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General NPI Number Information
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NPI Number | 1093702771
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO MUNOZ RIVERA INC
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 04/07/2017
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Provider Practice Location Address
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Address Line | # 51 ESMERALDA AVE,
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City | GUAYNABO
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State | PR
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Zip | 00969-0000
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Country | US
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Telephone | 787-720-5462
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Fax | 787-720-0745
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Provider Business Mailing Address
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Address Line | # 51 ESMERALDA AVENUE, URBANIZACION MUNOZ RIVERA
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-720-5462
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Fax | 787-720-0745
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LOURDES PEREZ
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Credential |
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Telephone | 787-720-5462
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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 | 291
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License Number State | PR
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