Provider Demographics
NPI:1487059036
Name:LNBV LLC
Entity type:Organization
Organization Name:LNBV LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:N
Authorized Official - Last Name:BEAUREGARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-397-9408
Mailing Address - Street 1:PO BOX 193128
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3128
Mailing Address - Country:US
Mailing Address - Phone:787-397-9408
Mailing Address - Fax:
Practice Address - Street 1:572 TENIENTE CESAR GONZALEZ
Practice Address - Street 2:URBANIZACION BALDRICH, HATO REY
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-397-9408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR182261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care