Provider Demographics
NPI:1538632724
Name:LUMEN VERA,MD PSC
Entity type:Organization
Organization Name:LUMEN VERA,MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VERA COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-735-0023
Mailing Address - Street 1:PO BOX 1327
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1327
Mailing Address - Country:US
Mailing Address - Phone:787-735-0023
Mailing Address - Fax:787-991-7097
Practice Address - Street 1:CARRETERA 726 KM 0.4 BO CAONILLAS
Practice Address - Street 2:HOSPITAL GENERAL MENONITA
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-1327
Practice Address - Country:US
Practice Address - Phone:787-735-0023
Practice Address - Fax:787-991-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty