Provider Demographics
NPI:1275287351
Name:CHANES, LORENA E (PA)
Entity Type:Individual
Prefix:DR
First Name:LORENA
Middle Name:E
Last Name:CHANES
Suffix:
Gender:F
Credentials:PA
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 3190
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-3190
Mailing Address - Country:US
Mailing Address - Phone:787-358-5233
Mailing Address - Fax:
Practice Address - Street 1:CALLE 3 NUM 80 SUR
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-1805
Practice Address - Country:US
Practice Address - Phone:787-866-1212
Practice Address - Fax:787-866-3322
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR001174-PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant