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General NPI Number Information
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NPI Number | 1912256090
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Entity Type | Organization
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Legal Business Name | METRO PAVIA HEALTHCARE CENTERS INC
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Dates
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Enumeration Date | 09/05/2012
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Last Update Date | 01/30/2013
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Provider Practice Location Address
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Address Line | CALLE MARINA NUM 38
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City | PONCE
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State | PR
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Zip | 00717-0000
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Country | US
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Telephone | 787-651-2855
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Fax | 787-651-2866
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Provider Business Mailing Address
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Address Line | PO BOX 9976 COTTO STATION
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City | ARECIBO
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State | PR
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Zip | 00613-9976
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Country | US
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Telephone | 787-651-2855
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Fax | 787-651-2866
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Authorized Official
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Title or Position | HOSP ADMINISTRATOR
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Name | MRS. MARIA L LOPEZ
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Credential |
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Telephone | 787-651-2855
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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 | 1214
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License Number State | PR
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