Provider Demographics
NPI:1255349650
Name:LEBRON-MULERO, JORGE ADRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ADRIAN
Last Name:LEBRON-MULERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7101
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7101
Mailing Address - Country:US
Mailing Address - Phone:787-646-9392
Mailing Address - Fax:787-284-2400
Practice Address - Street 1:EDIFICIO MICHELLE PLAZA
Practice Address - Street 2:SUITE 212 BARRIO . BUCANA VILLA FLORES
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-646-9392
Practice Address - Fax:787-284-2400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11198208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics