Provider Demographics
NPI:1124004395
Name:COLOMBANY LORENZO, HECTOR J (MD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:J
Last Name:COLOMBANY LORENZO
Suffix:
Gender:M
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:URB JARDINES DE BORINQUEN
Mailing Address - Street 2:D14
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-0001
Mailing Address - Country:US
Mailing Address - Phone:787-877-2121
Mailing Address - Fax:787-877-2145
Practice Address - Street 1:111 ST KM 2.5 BO PALMAR
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-0000
Practice Address - Country:US
Practice Address - Phone:787-877-2123
Practice Address - Fax:787-877-2145
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12303207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89860Medicare ID - Type Unspecified
PRH82883Medicare UPIN