Healthcare Provider Details

I. General information

NPI: 1275118309
Provider Name (Legal Business Name): LM MEDICAL SERVICES CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 03/10/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR #2 KM 47.7
MANATI PR
00674
US

IV. Provider business mailing address

URB SABANERA DE DORADO 478 CAMINO DE LA VEGA
DORADO PR
00646
US

V. Phone/Fax

Practice location:
  • Phone: 787-854-3322
  • Fax:
Mailing address:
  • Phone: 787-367-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. LEMUEL MARTINEZ BONILLA
Title or Position: PRESIDENT
Credential: MD
Phone: 787-367-9096