Healthcare Provider Details

I. General information

NPI: 1952315657
Provider Name (Legal Business Name): GLOBAL DIAGNOSTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

848 CALLE HOSTOS URB. HYDE PARK
SAN JUAN PR
00927-4216
US

IV. Provider business mailing address

848 CALLE HOSTOS URB. HYDE PARK
SAN JUAN PR
00927-4216
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-8018
  • Fax: 787-758-0048
Mailing address:
  • Phone: 787-758-8018
  • Fax: 787-758-0048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StatePR

VIII. Authorized Official

Name: MARIO ESTUARDO MIJANGOS
Title or Position: EXECUTIVE DIRECTOR & COO
Credential:
Phone: 407-466-1332