Provider Demographics
NPI:1386064558
Name:LMV GASTROENTEROLOGY PSC
Entity type:Organization
Organization Name:LMV GASTROENTEROLOGY PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LILLIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORALES-VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-525-6075
Mailing Address - Street 1:PO BOX 16598
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-6598
Mailing Address - Country:US
Mailing Address - Phone:787-525-6075
Mailing Address - Fax:
Practice Address - Street 1:1449 CALLE AMERICO SALAS STE 103
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-2104
Practice Address - Country:US
Practice Address - Phone:787-525-6075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-25
Last Update Date:2014-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17493207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty