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General NPI Number Information
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NPI Number | 1053559203
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO SANTA MARIA
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Dates
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Enumeration Date | 01/27/2009
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | CALLE FERROCARRIL 450 SANTA MARIA MEDICAL BUILDING OFICINA 103
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City | PONCE
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State | PR
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Zip | 00717
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Country | US
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Telephone | 787-844-4774
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Fax | 787-813-5781
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Provider Business Mailing Address
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Address Line | PO BOX 8173
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City | PONCE
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State | PR
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Zip | 00732-8173
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Country | US
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Telephone | 787-844-4774
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Fax | 787-813-5781
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. AGNES M CINTRON
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Credential | M.T.
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Telephone | 787-844-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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