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General NPI Number Information
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NPI Number | 1679967301
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO CDT DE RINCON
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Dates
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Enumeration Date | 03/19/2015
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Last Update Date | 03/19/2015
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Provider Practice Location Address
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Address Line | CARR. 115 KM 13.1 BARRIO PUEBLO
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City | RINCON
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State | PR
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Zip | 00677
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Country | US
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Telephone | 787-502-0242
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 CARR 8177 STE 26 PMB 229
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City | GUAYNABO
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State | PR
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Zip | 00966-3762
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Country | US
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Telephone | 787-502-0242
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. MIGUEL ANZALOTA
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Credential |
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Telephone | 787-502-0242
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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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