Provider Demographics
NPI:1255946034
Name:HERMINA, LORELIS (MD)
Entity type:Individual
Prefix:DR
First Name:LORELIS
Middle Name:
Last Name:HERMINA
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:HC 3 BOX 12458
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-7339
Mailing Address - Country:US
Mailing Address - Phone:787-372-5969
Mailing Address - Fax:
Practice Address - Street 1:BO. YEGUADA SECTOR ARIAS
Practice Address - Street 2:CARR. 485 KM 4.0
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-372-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15129I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice