Provider Demographics
NPI:1881804599
Name:LLORENS, EDGARDO (MD, OM)
Entity type:Individual
Prefix:DR
First Name:EDGARDO
Middle Name:
Last Name:LLORENS
Suffix:
Gender:M
Credentials:MD, OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 CALLE JULIO ANDINO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-2206
Mailing Address - Country:US
Mailing Address - Phone:787-644-4626
Mailing Address - Fax:
Practice Address - Street 1:BARRIO SAN ANTON, LOTE 4,#858
Practice Address - Street 2:SECTOR INDUSTRIAL PARQUE ESCORIAL
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR93622083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine