MEDICARE: LUIS LEBRON M.D.

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	146D00000X	Personal Emergency Response Attendant	10792	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DM10409-1/BL3343097	OTHER	PR	NARCOTIC LISENCE
2	10792	OTHER	PR	MD.P.R. LISENCE

General Provider Information

NPI Number	:	1427032689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUIS LEBRON M.D.

Provider Business Mailing Address
First Line	:	CAPRI ST.
Second Line	:	URB.PASEO LAS BRISAS
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-761-1701
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 CALLE CAPRI
Second Line	:	URB. PASEO LAS BRISAS
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5947
Country	:	US
Telephone Number	:	787-761-1701
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/08/2007

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Directions to “ LUIS LEBRON M.D.” Practice Location

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