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General NPI Number Information
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NPI Number | 1528316593
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Entity Type | Organization
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Legal Business Name | MILAGROS DEFILLO GARCIA ESTATE
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Dates
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Enumeration Date | 08/24/2012
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Last Update Date | 08/24/2012
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Provider Practice Location Address
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Address Line | 147 CALLE LUIS MUNOZ RIVERA
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City | GUAYANILLA
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State | PR
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Zip | 00656-1814
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Country | US
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Telephone | 787-835-2705
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Fax | 787-835-2705
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Provider Business Mailing Address
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Address Line | PO BOX 560362
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City | GUAYANILLA
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State | PR
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Zip | 00656-0362
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Country | US
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Telephone | 787-835-2705
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Fax | 787-835-2705
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GRETCHEN M FRANCESCHINI
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Credential |
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Telephone | 787-835-2705
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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 | 217
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License Number State | PR
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