Healthcare Provider Details

I. General information

NPI: 1275691438
Provider Name (Legal Business Name): WED DIAGNOSTICS WORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB ATENAS MARGINAL ELLIOT VELEZ B41
MANATI PR
00674
US

IV. Provider business mailing address

PO BOX 849
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-3139
  • Fax: 787-854-3870
Mailing address:
  • Phone: 787-884-3139
  • Fax: 787-854-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. EDA TORRES
Title or Position: PRESIDENTA
Credential:
Phone: 787-884-3139