Provider Demographics
NPI:1063882439
Name:LGF LLC
Entity type:Organization
Organization Name:LGF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHILD AND ADOLESCENTS PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-641-0773
Mailing Address - Street 1:1357 AVE ASHFORD
Mailing Address - Street 2:PMB 282
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1400
Mailing Address - Country:US
Mailing Address - Phone:787-641-0773
Mailing Address - Fax:
Practice Address - Street 1:1357 AVE ASHFORD
Practice Address - Street 2:PMB 282
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1400
Practice Address - Country:US
Practice Address - Phone:787-641-0773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10984261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health