Provider Demographics
NPI:1972982452
Name:DRELLORENS LLC
Entity type:Organization
Organization Name:DRELLORENS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:LLORENS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:787-864-0965
Mailing Address - Street 1:PO BOX 2284
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2284
Mailing Address - Country:US
Mailing Address - Phone:787-864-0965
Mailing Address - Fax:787-866-3443
Practice Address - Street 1:PLAZA GUAYAMA MALL
Practice Address - Street 2:SUITE 80
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-0965
Practice Address - Fax:787-866-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1966261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental