Healthcare Provider Details

I. General information

NPI: 1205278090
Provider Name (Legal Business Name): MILAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 185 KM 12.5 BARRIO CEDROS
CAROLINA PR
00985-0000
US

IV. Provider business mailing address

353 CAMINO LOS LIRIOS URB SABANERA DEL RIO
GURABO PR
00778-5249
US

V. Phone/Fax

Practice location:
  • Phone: 787-776-2492
  • Fax:
Mailing address:
  • Phone: 787-632-7638
  • Fax: 787-744-2016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number936
License Number StatePR

VIII. Authorized Official

Name: JOEL ESTRADA
Title or Position: OWNER
Credential: MT
Phone: 787-632-7638