Provider Demographics
NPI:1255525044
Name:MONCERRATE, LUZ (LPN)
Entity type:Individual
Prefix:MS
First Name:LUZ
Middle Name:
Last Name:MONCERRATE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7TH STREET METROPOLIS URB
Mailing Address - Street 2:APT.C-24
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-220-6597
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION METROPOLIS 7TH STREET
Practice Address - Street 2:APT.C-24
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-220-6597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021321164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse