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General NPI Number Information
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NPI Number | 1396029369
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO JARDINES II
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Dates
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Enumeration Date | 10/07/2011
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | CARRETERRA 857 KM 0.4 CANOVANILLAS
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City | CAROLINA
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State | PR
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Zip | 00987
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Country | US
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Telephone | 787-752-9375
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Fax | 787-946-0899
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Provider Business Mailing Address
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Address Line | PO BOX 1965
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City | CAROLINA
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State | PR
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Zip | 00984-1965
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Country | US
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Telephone | 787-752-9375
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Fax | 787-946-0899
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWIN W VAZQUEZ
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Credential |
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Telephone | 787-752-9372
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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 | 1068
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License Number State | PR
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