Provider Demographics
NPI:1871558999
Name:CLINCA DR LORENZO RIERA
Entity type:Organization
Organization Name:CLINCA DR LORENZO RIERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:RIERA
Authorized Official - Last Name:MATIENZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-256-4541
Mailing Address - Street 1:PO BOX 16557
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-6557
Mailing Address - Country:US
Mailing Address - Phone:787-256-4541
Mailing Address - Fax:787-256-7610
Practice Address - Street 1:LOCAL AA8 LOIZA VALLEY MALL
Practice Address - Street 2:
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729
Practice Address - Country:US
Practice Address - Phone:787-256-4541
Practice Address - Fax:787-256-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H55698Medicare UPIN
20341Medicare ID - Type Unspecified