Healthcare Provider Details
I. General information
NPI: 1538229265
Provider Name (Legal Business Name): LABORATORIO CLINICO SILMEND I
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/11/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CALLE BARCELO 59
VILLALBA PUERTO RICO
00766
UM
IV. Provider business mailing address
CALLE BARCELO 59
VILLALBA PUERTO RICO
00766
UM
V. Phone/Fax
- Phone: 787-847-0150
- Fax: 787-847-0150
- Phone: 787-847-0150
- Fax: 787-847-0150
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | 387 |
| License Number State | PR |
VIII. Authorized Official
Name: MRS.
NORMA I.
SILVAGNOLI
COLLAZO
Title or Position: DIRECTOR
Credential: BSMT
Phone: 787-847-0150