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General NPI Number Information
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NPI Number | 1164417168
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Entity Type | Organization
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Legal Business Name | CARIBE PATHOLOGY CSP
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Dates
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Enumeration Date | 09/15/2005
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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 349 KM. 2.7 CERRO LAS MESAS HOSPITAL BELLA VISTA
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City | MAYAGUEZ
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State | PR
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Zip | 00680-0000
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Country | US
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Telephone | 787-834-1021
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Fax | 787-834-1051
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Provider Business Mailing Address
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Address Line | PO BOX 3605
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City | MAYAGUEZ
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State | PR
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Zip | 00681-3605
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Country | US
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Telephone | 787-834-1021
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Fax | 787-834-1051
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Authorized Official
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Title or Position | OFFICE ADMINISTRATOR
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Name | MRS. IVETTE MEJIAS
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Credential |
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Telephone | 787-834-1021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | PR
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