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General NPI Number Information
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NPI Number | 1639143886
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO AMUNDARAY, INC
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Dates
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Enumeration Date | 02/15/2006
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 8155 CALLE CONCORDIA STE 101
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City | PONCE
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State | PR
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Zip | 00717-1547
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Country | US
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Telephone | 787-842-9760
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Fax | 787-844-0898
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Provider Business Mailing Address
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Address Line | 2457 CALLE EUREKA
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City | PONCE
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State | PR
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Zip | 00717-2219
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Country | US
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Telephone | 787-842-9760
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Fax | 787-844-0898
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MRS. DAGMAR L. SANTIAGO
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Credential |
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Telephone | 787-842-9760
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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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