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General NPI Number Information
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NPI Number | 1285332353
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Entity Type | Organization
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Legal Business Name | SPECIALTY LABS OF PUERTO RICO
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 04/02/2024
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Provider Practice Location Address
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Address Line | 142 CALLE MAYAGUEZ
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City | SAN JUAN
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State | PR
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Zip | 00917-5163
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Country | US
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Telephone | 787-274-0551
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Fax | 866-537-0423
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Provider Business Mailing Address
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Address Line | PO BOX 741621
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City | BOYNTON BEACH
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State | FL
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Zip | 33474-1621
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Country | US
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Telephone | 787-274-0551
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Fax | 787-332-1736
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. DANIEL LEGER
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Credential |
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Telephone | 787-274-0551
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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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