Provider Demographics
NPI:1407171010
Name:LERTORA, JUAN JOSE LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE LUIS
Last Name:LERTORA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10 CENTER DRIVE MSC 1352
Mailing Address - Street 2:BUILDING 10, B1L403
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-496-9425
Mailing Address - Fax:301-435-5275
Practice Address - Street 1:10 CENTER DRIVE MSC 1352
Practice Address - Street 2:NIH CLINICAL CENTER, BUILDING 10, B1L403
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-9425
Practice Address - Fax:301-435-5275
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
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Provider Licenses
StateLicense IDTaxonomies
LA05296R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine