Provider Demographics
NPI:1881852044
Name:LLORENS, JUAN MIGUEL I
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:MIGUEL
Last Name:LLORENS
Suffix:I
Gender:M
Credentials:
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 528
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-0528
Mailing Address - Country:US
Mailing Address - Phone:787-896-2329
Mailing Address - Fax:
Practice Address - Street 1:13 CALLE ANDRES MENDEZ LICIAGA
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2275
Practice Address - Country:US
Practice Address - Phone:787-896-2329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031551Medicare PIN