Provider Demographics
NPI:1982947024
Name:LMG MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:LMG MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIZZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTALVO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-752-6767
Mailing Address - Street 1:PARQUE ESCORIAL, AVE. SUR 3510
Mailing Address - Street 2:COND. THE RESIDENCES,, BLDG. 6, APT. 13
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-752-6767
Mailing Address - Fax:787-752-6773
Practice Address - Street 1:4A-S2 FRAGOSO AVE.
Practice Address - Street 2:VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-7321
Practice Address - Country:US
Practice Address - Phone:787-752-6767
Practice Address - Fax:787-752-6773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR207Q00000X261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRET644AOtherPTAN