Provider Demographics
NPI:1831538271
Name:SUERO - LORA, JENS (MD)
Entity type:Individual
Prefix:
First Name:JENS
Middle Name:
Last Name:SUERO - LORA
Suffix:
Gender:M
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 9545
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-9545
Mailing Address - Country:US
Mailing Address - Phone:787-864-4300
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL MENONITA DE GUAYAMA SUITE 208
Practice Address - Street 2:AVE. PEDRO ALBIZU CAMPOS, URB. LAHACIENDA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR196122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology