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General NPI Number Information
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NPI Number | 1881804599
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Entity Type | Individual
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Provider Name | EDGARDO LLORENS MD, OM
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BARRIO SAN ANTON, LOTE 4,#858 SECTOR INDUSTRIAL PARQUE ESCORIAL
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City | CAROLINA
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State | PR
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Zip | 00984
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Country | US
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Telephone | 787-757-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 670 CALLE JULIO ANDINO
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City | SAN JUAN
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State | PR
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Zip | 00924-2206
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Country | US
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Telephone | 787-644-4626
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Fax |
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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 | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 9362
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License Number State | PR
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