Provider Demographics
NPI:1740482561
Name:LIBERTAD MONTANEZ DELERME
Entity type:Organization
Organization Name:LIBERTAD MONTANEZ DELERME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LIBERTAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-723-7990
Mailing Address - Street 1:PO BOX 14441
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4441
Mailing Address - Country:US
Mailing Address - Phone:787-723-7990
Mailing Address - Fax:787-276-0435
Practice Address - Street 1:1415 AVE FERNANDEZ JUNCOS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2658
Practice Address - Country:US
Practice Address - Phone:787-723-7990
Practice Address - Fax:787-276-0435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD99523Medicare UPIN
PR0026852Medicare ID - Type Unspecified