Provider Demographics
NPI:1063186179
Name:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Entity type:Organization
Organization Name:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AYUDANTE EJECUTIVA
Authorized Official - Prefix:
Authorized Official - First Name:TARY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-264-1912
Mailing Address - Street 1:PO BOX 5100
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-9801
Mailing Address - Country:US
Mailing Address - Phone:787-264-1912
Mailing Address - Fax:787-264-0220
Practice Address - Street 1:AVENIDA UNIVERSIDAD INTERAMERICANA
Practice Address - Street 2:CARR. 102 KM 30 HM 6
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-264-1912
Practice Address - Fax:787-264-0220
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTER AMERICAN UNIVERSITY OF PUERTO RICO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory