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General NPI Number Information
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NPI Number | 1942378450
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Entity Type | Organization
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Legal Business Name | MARLYN RODRIGUEZ GINORIO
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 9 CALLE DR BASORA N SUITE # 2
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4893
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Country | US
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Telephone | 787-832-5040
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Fax | 787-832-5040
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Provider Business Mailing Address
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Address Line | 9 CALLE DR BASORA N SUITE # 2
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4893
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Country | US
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Telephone | 787-832-5040
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Fax | 787-832-5040
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MARLYN RODRIGUEZ
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Credential | M.T.A.S.C.P.
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Telephone | 787-832-5040
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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 | 49
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License Number State | PR
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