MEDICARE: EMPRESAS FIGUEROA,GOYTIA Y ASOCIADOS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	852	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	40D0882044	OTHER	PR	CLIA

General Provider Information

NPI Number	:	1124107107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPRESAS FIGUEROA,GOYTIA Y ASOCIADOS INC.

Provider Business Mailing Address
First Line	:	PO BOX 1468
Second Line	:
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00977-1468
Country	:	US
Telephone Number	:	787-760-4500
Fax Number	:	787-283-2950

Provider Business Practice Location Address
First Line	:	KM 8.6 BARRIO DOS BOCAS
Second Line	:	CARR.181
City	:	TRUJILLO ALTO
State	:	PR
Zip	:	00976-0000
Country	:	US
Telephone Number	:	787-160-4500
Fax Number	:	787-286-2950

Authorized Official
Title or Position	:	CO OWNER ADMINISTRATOR
Name	:	MRS. SONYA LYSSETTE GOYTIA
Credential	:	MS MT ASCP
Telephone Number	:	787-760-4500

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	12/12/2007

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