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General NPI Number Information
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NPI Number | 1124157821
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Entity Type | Organization
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Legal Business Name | CENTRAL MEDICAL LAB CORP
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 5-5 CALLE 8 SABANA GARDENS
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City | CAROLINA
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State | PR
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Zip | 00983-2966
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Country | US
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Telephone | 787-762-0445
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Fax | 787-750-7555
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Provider Business Mailing Address
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Address Line | 5-5 CALLE 8 SABANA GARDENS
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City | CAROLINA
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State | PR
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Zip | 00983-2966
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Country | US
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Telephone | 787-762-0445
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Fax | 787-750-7555
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Authorized Official
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Title or Position | PRESIDENTE
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Name | DR. ARMANDO VICENTE
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Credential | MD
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Telephone | 787-762-0445
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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 | 1049
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License Number State | PR
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