Provider Demographics
NPI:1053445775
Name:LORENZO PUESAN, CRISTINA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:ELIZABETH
Last Name:LORENZO PUESAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2411
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2411
Mailing Address - Country:US
Mailing Address - Phone:787-866-0000
Mailing Address - Fax:787-866-0000
Practice Address - Street 1:ASHFORD AVE. #128, ASHFORD MEDICAL PLAZA SUITE 201
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00978-2411
Practice Address - Country:US
Practice Address - Phone:787-864-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10155208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice