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General NPI Number Information
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NPI Number | 1952443533
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Entity Type | Organization
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Legal Business Name | LYDIA E. LAUREANO MENA
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 271 AVE BARBOSA
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City | SAN JUAN
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State | PR
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Zip | 00917-3310
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Country | US
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Telephone | 787-753-7356
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Fax | 787-767-8100
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Provider Business Mailing Address
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Address Line | 271 AVE BARBOSA ESQ DUARTE
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City | SAN JUAN
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State | PR
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Zip | 00917-3310
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Country | US
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Telephone | 787-753-7356
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Fax | 787-767-8100
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Authorized Official
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Title or Position | OWNER
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Name | MISS LYDIA LAUREANO MENA
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Credential |
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Telephone | 787-753-7356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 07F2071
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License Number State | PR
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