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General NPI Number Information
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NPI Number | 1871633164
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Entity Type | Organization
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Legal Business Name | MARIBEL DIAZ RUIZ LABORATORY SERVICES INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 513 AVE HOSTOS BALDRICH
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City | SAN JUAN
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State | PR
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Zip | 00918-3235
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Country | US
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Telephone | 787-758-3220
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Fax | 787-758-3203
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Provider Business Mailing Address
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Address Line | PO BOX 190849
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City | SAN JUAN
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State | PR
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Zip | 00919-0849
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Country | US
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Telephone | 787-758-3220
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Fax | 787-758-3203
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | MISS MARIBEL DIAZ
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Credential | M.T.
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Telephone | 787-758-3220
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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 | 1085
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License Number State | PR
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