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General NPI Number Information
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NPI Number | 1093850604
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Entity Type | Organization
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Legal Business Name | LABOROTORIO CLINICO Y BACTERIOLOGICO HATILLO INC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | CARR 119 KM 0.69 ESTANCIAS DE HATILLO
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City | HATILLO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-820-9268
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Fax | 787-820-9268
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Provider Business Mailing Address
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Address Line | PO BOX 141394
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City | ARECIBO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-820-9268
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Fax | 787-820-9268
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Authorized Official
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Title or Position | CLINICAL DIRECTOR & OWNER
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Name | MRS. ROSA TOLEDO RIVERA
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Credential | MT. LIC 2750 OWNER
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Telephone | 787-820-9268
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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 | 1011
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License Number State | PR
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