Healthcare Provider Details

I. General information

NPI: 1437104346
Provider Name (Legal Business Name): PULMO LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 PONCE BYP STE 702
PONCE PR
00717-1321
US

IV. Provider business mailing address

2225 PONCE BYP STE 702
PONCE PR
00717-1321
US

V. Phone/Fax

Practice location:
  • Phone: 787-843-7105
  • Fax: 787-844-0225
Mailing address:
  • Phone: 787-843-7105
  • Fax: 787-844-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HECTOR R ROSADO-TOLEDO
Title or Position: MEDICAL DIRECTOR
Credential: MD, FACP, FCCP
Phone: 787-840-8284