Provider Demographics
NPI:1063049039
Name:HERDOCIA-LLUBERES, CLAUDIA SUZETTE
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SUZETTE
Last Name:HERDOCIA-LLUBERES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CALLE POPPY APT A4
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6338
Mailing Address - Country:US
Mailing Address - Phone:787-675-0287
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00935-6338
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program