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General NPI Number Information
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NPI Number | 1588730923
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO DEL PARQUE INC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 352 CALLE DEL PARQUE
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City | SAN JUAN
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State | PR
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Zip | 00912-3702
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Country | US
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Telephone | 787-724-4161
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Fax | 787-724-4161
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Provider Business Mailing Address
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Address Line | PO BOX 41028
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City | SAN JUAN
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State | PR
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Zip | 00940-1028
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Country | US
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Telephone | 787-724-4161
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Fax | 787-724-4161
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Authorized Official
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Title or Position | DIRECTOR
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Name | CARLOS M HIRALDO
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Credential | TECNOLOGO MEDICO
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Telephone | 787-724-4161
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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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