Healthcare Provider Details

I. General information

NPI: 1952310740
Provider Name (Legal Business Name): MEDICAL PHARMACY & LABORATORY ADMINISTRATIVE SERVICE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

CALLE BARBOSA ESQ SICILIA 404
SAN JUAN PR
00926
US

IV. Provider business mailing address

PO BOX 51991
TOA BAJA PR
00950-1991
US

V. Phone/Fax

Practice location:
  • Phone: 787-707-1943
  • Fax: 787-706-8823
Mailing address:
  • Phone: 787-707-1943
  • Fax: 787-706-8823

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. MIGUEL ANGEL ROBLEDO
Title or Position: PRESIDENTE
Credential:
Phone: 787-707-1943