1912980301 NPI number — DR. LILLIAM CARABALLO LEMELL DPM, MPH

Table of content: ADELA MARIE COLMENERO PMHNP-BC (NPI 1801626734)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912980301 NPI number — DR. LILLIAM CARABALLO LEMELL DPM, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEMELL
Provider First Name:
LILLIAM
Provider Middle Name:
CARABALLO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RODRIQUEZ
Provider Other First Name:
LILLIAM
Provider Other Middle Name:
CARABALLO
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPM, MPH
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1912980301
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/10/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 800677
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COTO LAUREL
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00780-0677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-841-2228
Provider Business Mailing Address Fax Number:
787-841-2220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TORRE SAN CRISTOBAL
Provider Second Line Business Practice Location Address:
SUITE 213
Provider Business Practice Location Address City Name:
COTO LAUREL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-841-2228
Provider Business Practice Location Address Fax Number:
787-841-2220
Provider Enumeration Date:
11/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  000030 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com