Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 8153 | PR |
NPI | 1295723716 |
---|---|
Provider Name | Dr. Lourdes R. Pedraza |
First Address | San Juan, PR 00912-3239 |
Second Address | San Juan, PR 00912-3239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 06/04/2012 |