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General NPI Number Information
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NPI Number | 1679783146
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICA DE CUIDADO MEDICO INC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 4 CALLE HOSPITAL
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City | CIALES
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State | PR
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Zip | 00638-3310
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Country | US
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Telephone | 787-871-1098
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Fax | 787-871-4883
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Provider Business Mailing Address
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Address Line | PO BOX 1347
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City | CIALES
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State | PR
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Zip | 00638-1347
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Country | US
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Telephone | 787-871-1098
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Fax | 787-871-4883
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Authorized Official
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Title or Position | SUPERVISORA
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Name | YESENIA DELGADO
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Credential | LIC.
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Telephone | 787-871-1098
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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 | 1020
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License Number State | PR
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