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General NPI Number Information
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NPI Number | 1376526061
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO EL PARAISO, INC.
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | URB EL CEREZAL 1648 CALLE PARANA STE 1
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City | SAN JUAN
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State | PR
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Zip | 00926-3145
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Country | US
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Telephone | 787-763-8573
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Fax | 787-763-8573
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Provider Business Mailing Address
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Address Line | URB EL CEREZAL 1648 CALLE PARANA STE 1
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City | SAN JUAN
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State | PR
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Zip | 00926-3145
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Country | US
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Telephone | 787-763-8573
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Fax | 787-763-8573
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | MOISES MENDEZ PEREZ
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Credential | ASCP; MT
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Telephone | 787-763-8573
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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 | 749
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License Number State | PR
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