Organization
LVS FAMILY MEDICINE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA M LOPERENA MONTALBAN (ADMINISTRATIVE ASSISTANT)
(787) 843-1700
Entity
Organization
Contact information
Practice address
8133 CALLE CONCORDIA, SUITE 202, PONCE, PR 00717-1543
(787) 843-1700
(787) 842-0900
Mailing address
PO BOX 5038, PONCE, PR 00733-5038
(787) 843-1700
(787) 842-0900
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13345
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13,345
LICENSE NUMBER
PR
Enumeration date
06/17/2011
Last updated
05/08/2013
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