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General NPI Number Information
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NPI Number | 1427911718
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Entity Type | Organization
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Legal Business Name | TERESITA LAB LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | AVE JESUS T PINERO
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City | SAN JUAN
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State | PR
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Zip | 00927-6704
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Country | US
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Telephone | 787-675-0112
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Fax |
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Provider Business Mailing Address
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Address Line | MIRABELLA VILLAGE CALLE CUARZO 23A
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-675-0112
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Fax | 787-675-0112
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Authorized Official
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Title or Position | CEO
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Name | JESSICA Z GONZALEZ QUIJANO
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Credential |
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Telephone | 787-675-0112
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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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