Provider Demographics
NPI:1174981245
Name:LENUS RESEARCH & MEDICAL GROUP
Entity type:Organization
Organization Name:LENUS RESEARCH & MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:305-796-3325
Mailing Address - Street 1:1414 NW 107TH AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2741
Mailing Address - Country:US
Mailing Address - Phone:305-592-4692
Mailing Address - Fax:
Practice Address - Street 1:1414 NW 107TH AVE STE 214
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2741
Practice Address - Country:US
Practice Address - Phone:305-592-4692
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLA452-105-77-287-0207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty