MEDICARE: LAB LORIMAR LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	849	PR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	583671509	OTHER		MAPFRE MEDICARE EXCELL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	800357	OTHER	MMM
2	30936	OTHER	TRIPLE S
3	583671509	OTHER	MAPFRE PR
4	583671509	OTHER	IMC
5	20033	OTHER	PMC
6	31903	OTHER	PROSSAM
8	20006	OTHER	AMERICAN HEALTH
9	583671509	OTHER	CIGNA
10	6760017	OTHER	HUMANA

General Provider Information

NPI Number	:	1063550861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAB LORIMAR LLC

Provider Business Mailing Address
First Line	:	PO BOX 388
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-0388
Country	:	US
Telephone Number	:	787-877-1236
Fax Number	:	787-877-1236

Provider Business Practice Location Address
First Line	:	65 CALLE PEDRO SANTOS STE 1
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-4015
Country	:	US
Telephone Number	:	787-877-1236
Fax Number	:	787-877-1236

Authorized Official
Title or Position	:	MD
Name	:	DR. JORGE L. MENDEZ COLON
Credential	:	MD
Telephone Number	:	787-877-7700

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	12/01/2025

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Directions to “LAB LORIMAR LLC ” Practice Location

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