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General NPI Number Information
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NPI Number | 1114033560
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Entity Type | Organization
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Legal Business Name | CARIBBEAN MEDICAL TESTING CENTER
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 300 CLEMSON ST UNIVERSITY GARDENS
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-754-6868
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Fax | 787-274-9280
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Provider Business Mailing Address
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Address Line | PO BOX 192071
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City | SAN JUAN
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State | PR
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Zip | 00919-2071
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Country | US
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Telephone | 787-754-6868
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Fax | 787-274-9280
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANGEL VALE
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Credential |
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Telephone | 787-754-6868
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 67
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 492
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License Number State | PR
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