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General NPI Number Information
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NPI Number | 1821777053
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Entity Type | Organization
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Legal Business Name | LABORATORIO CLINICO KIKITA LLC
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | AVE. PEDRO ALBIZU CAMPOS #155 BO. MAMEYAL
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-515-4307
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Fax |
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Provider Business Mailing Address
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Address Line | HC-46 BOX 6040
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City | DORADO
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State | PR
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Zip | 00646
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Country | US
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Telephone | 787-515-4307
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARILYN MARRERO NIEVES
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Credential | MEDICAL TECHNOLIGIST
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Telephone | 787-515-4307
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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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