Provider Demographics
NPI:1063694743
Name:SILVIA BAEZ
Entity type:Organization
Organization Name:SILVIA BAEZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECHNOLOGY AND OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:SILVIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:BAEZ BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BS MT
Authorized Official - Phone:787-856-0215
Mailing Address - Street 1:HC 5 BOX 7465
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9727
Mailing Address - Country:US
Mailing Address - Phone:787-856-0215
Mailing Address - Fax:787-856-0215
Practice Address - Street 1:27 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-0215
Practice Address - Fax:787-856-0215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR225291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory