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General NPI Number Information
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NPI Number | 1740300839
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Entity Type | Individual
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Provider Name | IDAMAR LAUREANO LANDRON M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | LOTE 1METRO OFFICE PARK SUITE 400
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-774-3344
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Fax | 787-774-6251
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Provider Business Mailing Address
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Address Line | 39 STREET SANTA JUANITA PMB 334 UU1
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City | BAYAMON
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State | PR
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Zip | 00956
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Country | US
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Telephone | 787-396-7423
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Fax | 787-288-1115
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11704
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License Number State | PR
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