Provider Demographics
NPI:1376701219
Name:LEBRON MEDICAL CARE INC
Entity type:Organization
Organization Name:LEBRON MEDICAL CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-271-3379
Mailing Address - Street 1:PO BOX 1204
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-1204
Mailing Address - Country:US
Mailing Address - Phone:787-271-3379
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA NUM 3 KM 1319
Practice Address - Street 2:BARRIO GUASIMA
Practice Address - City:ARROYO
Practice Address - State:PR
Practice Address - Zip Code:00714
Practice Address - Country:US
Practice Address - Phone:787-271-3379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTC AMB 4593416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0059709Medicare PIN