MEDICARE: GERENA CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1235089186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERENA CLINIC LLC

Provider Business Mailing Address
First Line	:	URB LEVITOWN JR5 7MA SECCION C/ LIZZIE GRAHAM
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-261-0740
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB LEVITOWN JR5 7MA SECCION C/ LIZZIE GRAHAM
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-261-0740
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CESAR G GERENA
Credential	:	MD
Telephone Number	:	787-261-0740

Provider Enumeration Date	:	01/30/2026
Last Update Date	:	01/30/2026

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