Provider Demographics
NPI:1275266389
Name:LMDC PRIMARY MEDICINE LLC
Entity Type:Organization
Organization Name:LMDC PRIMARY MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY CARE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:DIAZ COLON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-879-3995
Mailing Address - Street 1:PO BOX 560
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-0560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 CALLE SAN FELIPE
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4605
Practice Address - Country:US
Practice Address - Phone:787-879-3995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-06
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty