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General NPI Number Information
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NPI Number | 1841244860
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Entity Type | Organization
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Legal Business Name | CMG PATHOLOGY LAB., CORP.
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | SAN JUAN HEALTH CTR SUITE 610
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City | SANTURCE
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State | PR
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Zip | 00907-2300
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Country | US
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Telephone | 787-721-1684
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Fax | 787-721-1684
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Provider Business Mailing Address
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Address Line | E12 CALLE MALAGA VISTAMAR MARINA ESTE
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City | CAROLINA
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State | PR
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Zip | 00983-1507
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Country | US
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Telephone | 787-723-1674
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Fax | 787-721-1684
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Authorized Official
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Title or Position | DIRECTOR
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Name | CARMEN MARGARITA GURREA
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Credential | MD
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Telephone | 787-721-1684
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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 | 854B
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License Number State | PR
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