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General NPI Number Information
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NPI Number | 1861856551
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Entity Type | Individual
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Provider Name | DEYSON LORENZO-RIOS MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 10000 AVE 65 INFANTERIA STE 303
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City | CAROLINA
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State | PR
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Zip | 00985-5672
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Country | US
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Telephone | 787-752-4304
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 365067
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City | SAN JUAN
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State | PR
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Zip | 00936-5067
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Country | US
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Telephone | 787-758-5500
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Fax | 787-767-0467
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 021312
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 021312
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | MD223992
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License Number State | OR
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