Provider Demographics
NPI:1427229665
Name:LM ANESTHESIA PSC
Entity Type:Organization
Organization Name:LM ANESTHESIA PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-430-7246
Mailing Address - Street 1:447 CALLE REINA DE LAS FLORES
Mailing Address - Street 2:HACIENDA REAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-9786
Mailing Address - Country:US
Mailing Address - Phone:787-430-7246
Mailing Address - Fax:888-768-6686
Practice Address - Street 1:AVE PINERO
Practice Address - Street 2:#291
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4003
Practice Address - Country:US
Practice Address - Phone:787-430-7246
Practice Address - Fax:888-768-6686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-16
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14372261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1033153630Medicare PIN