Individual
LLOYD MERINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
500 N MUNDO DR, DULCE, NM 87528-5176
(575) 759-3291
(575) 759-3532
Mailing address
PO BOX 187, DULCE, NM 87528-0187
(575) 759-3291
(575) 759-3532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2017-0084
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08800707
—
NM
Enumeration date
10/02/2017
Last updated
04/18/2023
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