Healthcare Provider Details
I. General information
NPI: 1124946199
Provider Name (Legal Business Name): LUMEN VERA, MD PSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CARRETERA 726 KM 0 HM 4 BO. CAONILLAS ENTRADA HOSPITAL MENONITA
AIBONITO PR
00705
US
IV. Provider business mailing address
PO BOX 1327
AIBONITO PR
00705-1327
US
V. Phone/Fax
- Phone: 787-735-0023
- Fax:
- Phone: 787-735-0023
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LUMEN
VERA
COLON
Title or Position: PRESIDENT
Credential: MD
Phone: 787-647-8123