Provider Demographics
NPI:1629711031
Name:MONTANEZ, LORIMAR (MD)
Entity Type:Individual
Prefix:
First Name:LORIMAR
Middle Name:
Last Name:MONTANEZ
Suffix:
Gender:F
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:PO BOX 1655
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-1655
Mailing Address - Country:US
Mailing Address - Phone:787-244-9891
Mailing Address - Fax:
Practice Address - Street 1:JARD DE SANTA ISABEL K10 CALLE 7
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-1921
Practice Address - Country:US
Practice Address - Phone:787-244-9891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22653208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice