| Street | San Luis 890 | ||
| City/Town | San Luis | ||
| State/Province/Region | Lima | ||
| Zip/Postal Code | 15019 | ||
| Phone Number | (01) 6128700 | ||
| Country | Peru |
| Full Name | Dra. Sofía De León Huerta | ||
| Gender | female | ||
| Birthday | 1982-05-19 | ||
| Social Security Number |
| Credit card brand | Mastercard | ||
| Credit card number | 5496022204247906 | ||
| Expire | 2027/10 | ||
| CVV | 946 |