MEDICARE: HATO REY PATHOLOGY ASSOCIATES

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	533	PR

General Provider Information

NPI Number	:	1497749196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HATO REY PATHOLOGY ASSOCIATES

Provider Business Mailing Address
First Line	:	PO BOX 366527
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-6527
Country	:	US
Telephone Number	:	787-765-7320
Fax Number	:	787-753-7656

Provider Business Practice Location Address
First Line	:	570 CALLE JUAN J JIMENEZ
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3722
Country	:	US
Telephone Number	:	787-765-7320
Fax Number	:	787-753-7656

Authorized Official
Title or Position	:	DIRECTOR MEDICO
Name	:	DR. RAFAEL R RAMIREZ WEISER
Credential	:	M.D.
Telephone Number	:	787-765-7320

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	08/22/2020

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