Provider Demographics
NPI:1205860806
Name:AMARO, LUIS ORLANDO (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:ORLANDO
Last Name:AMARO
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 1:9151 ESTATE THOMAS
Mailing Address - Street 2:FOOTHILLS PROFESSIONAL BLDG STE#103
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802
Mailing Address - Country:US
Mailing Address - Phone:340-776-0365
Mailing Address - Fax:
Practice Address - Street 1:9151 ESTATE THOMAS
Practice Address - Street 2:FOOTHILLS PROFESSIONAL BLDG STE#103
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-776-0365
Practice Address - Fax:340-776-0369
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIVI1322207R00000X, 208000000X
FLME94422207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI089201OtherBLUE CROSS BLUE SHIELD
VI0023317Medicare UPIN
VII36498Medicare UPIN