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General NPI Number Information
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NPI Number | 1245407527
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Entity Type | Organization
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Legal Business Name | NIMAR V & M, INC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 59 AVE PONCE DE LEON BO AMELIA
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City | GUAYNABO
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State | PR
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Zip | 00965-5618
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Country | US
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Telephone | 787-644-8215
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Fax |
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Provider Business Mailing Address
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Address Line | 624 CARR 8860 APT 2603 CAMINO DE LA REINA
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City | TRUJILLO ALTO
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State | PR
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Zip | 00976-5444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CARMEN V ORTIZ
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Credential | MEDICAL TECHNOLOGIST
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Telephone | 787-644-8215
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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 |
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License Number State |
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