Healthcare Provider Details

I. General information

NPI: 1891610028
Provider Name (Legal Business Name): LABORATORIO CLINICO ALTAMIRA PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE JESUS T PINEIRO ESQ 1900 MARGINAL EXPRESO MARTINEZ NADAL
SAN JUAN PR
00921
US

IV. Provider business mailing address

35 CALLE JUAN C BORBON STE 69
GUAYNABO PR
00969-5375
US

V. Phone/Fax

Practice location:
  • Phone: 787-287-0645
  • Fax:
Mailing address:
  • Phone: 787-287-0645
  • Fax:

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: NILSA MARRERO
Title or Position: PRESIDENT
Credential:
Phone: 939-642-0451