Provider Demographics
NPI:1366755142
Name:CABEZUDO, LUZ MINERBA (LPN)
Entity type:Individual
Prefix:MRS
First Name:LUZ
Middle Name:MINERBA
Last Name:CABEZUDO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 12262
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-9621
Mailing Address - Country:US
Mailing Address - Phone:787-712-0432
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 12262
Practice Address - Street 2:
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778-9621
Practice Address - Country:US
Practice Address - Phone:787-712-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR015976164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse