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General NPI Number Information
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NPI Number | 1912167206
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Entity Type | Individual
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Provider Name | LOURDES DEL PILAR CORDERO OPTOMETRIST OD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2008
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | WALMART VISION CENTER PARQUE ESCORIAL
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 787-257-0500
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Fax | 787-257-0670
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Provider Business Mailing Address
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Address Line | TIERRALTA II - 0-5 LAS AGUILAS ST
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-403-7408
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Fax | 787-720-0321
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 541
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License Number State | PR
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