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General NPI Number Information
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NPI Number | 1750484135
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO BEAUCHAMP
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 10 DR VAZQUEZ COLON
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City | FLORIDA
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State | PR
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Zip | 00650
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Country | US
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Telephone | 787-822-3364
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Fax | 787-822-3364
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Provider Business Mailing Address
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Address Line | 10 DR VAZQUEZ COLON
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City | FLORIDA
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State | PR
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Zip | 00650
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Country | US
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Telephone | 787-822-3364
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Fax | 787-822-3364
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Authorized Official
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Title or Position | DIRECTOR
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Name | CARMEN D BEAUCHAMP
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Credential | BSMT
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Telephone | 787-822-0081
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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 | 831
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License Number State | PR
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