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NPI Code Detail

MEDICARE: LABORATORIO CLINICO LA CUMBRE, INC

MEDICARE: LABORATORIO CLINICO LA CUMBRE, INC
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
1291U00000XClinical Medical Laboratory505PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1505OTHERPRLICENSE PR

General Provider Information

NPI Number : 1174532568
Entity Type Code : Organization
Provider Name (Legal Business Name) : LABORATORIO CLINICO LA CUMBRE, INC
Provider Business Mailing Address
First Line : AVE PONCE DE LEON
Second Line : #662
City : SAN JUAN
State : PR
Zip : 00918-1000
Country : US
Telephone Number : 787-720-7788
Fax Number : 787-287-6495
Provider Business Practice Location Address
First Line : 264 CALLE SIERRA MORENA
Second Line : URB. LA CUMBRE
City : SAN JUAN
State : PR
Zip : 00926-5539
Country : US
Telephone Number : 787-720-7788
Fax Number : 787-287-6495
Authorized Official
Title or Position : PRESIDENT
Name : MR. JOSE O ALSINA
Credential : LIC.
Telephone Number : 787-720-7788
Provider Enumeration Date : 08/05/2006
Last Update Date : 08/22/2020

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