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NPI Code Detail

MEDICARE: LABORATORIO CLINICA DE CUIDADO MEDICO INC

MEDICARE: LABORATORIO CLINICA DE CUIDADO MEDICO 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 Laboratory1020PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11020OTHERPRLICENCIA

General Provider Information

NPI Number : 1679783146
Entity Type Code : Organization
Provider Name (Legal Business Name) : LABORATORIO CLINICA DE CUIDADO MEDICO INC
Provider Business Mailing Address
First Line : PO BOX 1347
Second Line :
City : CIALES
State : PR
Zip : 00638-1347
Country : US
Telephone Number : 787-871-1098
Fax Number : 787-871-4883
Provider Business Practice Location Address
First Line : 4 CALLE HOSPITAL
Second Line :
City : CIALES
State : PR
Zip : 00638-3310
Country : US
Telephone Number : 787-871-1098
Fax Number : 787-871-4883
Authorized Official
Title or Position : SUPERVISORA
Name : YESENIA DELGADO
Credential : LIC.
Telephone Number : 787-871-1098
Provider Enumeration Date : 05/23/2007
Last Update Date : 10/29/2013

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