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General NPI Number Information
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NPI Number | 1346545175
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO PASEO DEL SUR INC
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | CENTRO COMERCIAL PASEO DEL SUR PLAZA, SUITE C BARRIO VALLAS TORRES 291 AVE. LOS CAOBOS
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City | PONCE
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State | PR
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Zip | 00731
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Country | US
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Telephone | 787-505-9195
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Fax |
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Provider Business Mailing Address
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Address Line | QINTAS DE MONSERRATE EL GRECO C1
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City | PONCE
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State | PR
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Zip | 00730-1706
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Country | US
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Telephone | 787-505-9195
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MRS. MARIA ESTHER COLON
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Credential | M.T.
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Telephone | 787-505-9195
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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 | PR
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