Healthcare Provider Details

I. General information

NPI: 1801887807
Provider Name (Legal Business Name): LABORATORIO CLINICO JELMAP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 CALLE DEGETAU
JUANA DIAZ PR
00795-1626
US

IV. Provider business mailing address

PO BOX 1749
JUANA DIAZ PR
00795-5503
US

V. Phone/Fax

Practice location:
  • Phone: 787-837-3067
  • Fax: 787-837-3067
Mailing address:
  • Phone: 787-837-3067
  • Fax: 787-837-3067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. ORLANDO F TORRES
Title or Position: OWNER DIRECTOR
Credential: MEDICAL TECHNOLOGIST
Phone: 787-837-3067