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General NPI Number Information
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NPI Number | 1902730252
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Entity Type | Organization
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Legal Business Name | LUNARIS MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 201 CALLE GAUTIER BENITEZ
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City | CAGUAS
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State | PR
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Zip | 00725-5527
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Country | US
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Telephone | 787-409-8918
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Fax |
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Provider Business Mailing Address
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Address Line | 3536 AVE SUR, COND THE RESIDENCES 1913
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City | CAROLINA
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State | PR
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Zip | 00987-5010
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Country | US
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Telephone | 787-409-8918
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MORAYMA ENID RIVERA NIEVES
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Credential | MEDICO
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Telephone | 787-409-8918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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