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General NPI Number Information
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NPI Number | 1346970712
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Entity Type | Organization
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Legal Business Name | MEDICO XPRESO MULTI GROUP LLC
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1790 AV. LAS LOMAS
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-942-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 688 CALLE MAR DEL NORTE
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City | DORADO
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State | PR
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Zip | 00646-4530
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Country | US
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Telephone | 787-942-3232
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEYRA NICOLE RIVERA HUREL
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Credential |
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Telephone | 787-459-5556
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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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