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General NPI Number Information
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NPI Number | 1114063062
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Entity Type | Organization
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Legal Business Name | LABORATORIO SAN FRANCISCO DE ASIS INC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | AVE NATIVO ALERS PLAZA COPPELIA OFFICE 101
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-868-8607
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1529
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 787-868-8607
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Fax |
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Authorized Official
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Title or Position | DIRECTORA
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Name | MRS. DAISY QUINONES
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Credential |
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Telephone | 787-868-8607
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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 | 940
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License Number State | PR
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