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General NPI Number Information
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NPI Number | 1144517988
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Entity Type | Organization
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Legal Business Name | LABORATORIO OCEAN FRONT INC
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Dates
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Enumeration Date | 06/30/2011
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Last Update Date | 06/30/2011
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Provider Practice Location Address
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Address Line | 5 CARR 686 # KM
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City | VEGA BAJA
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State | PR
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Zip | 00693-3270
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Country | US
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Telephone | 787-807-0007
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2221
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City | MANATI
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State | PR
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Zip | 00674-2221
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Country | US
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Telephone | 787-807-0007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA MELENDEZ
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Credential |
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Telephone | 787-807-0007
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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 | 1217
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License Number State | PR
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