Provider Demographics
NPI:1063883304
Name:MULTI MEDICAL FACILITIES CLINICAL LABORATORY
Entity type:Organization
Organization Name:MULTI MEDICAL FACILITIES CLINICAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:CELENIA
Authorized Official - Last Name:CASTELLANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-705-8677
Mailing Address - Street 1:PO BOX 19400
Mailing Address - Street 2:PMB 196
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4000
Mailing Address - Country:US
Mailing Address - Phone:787-705-8677
Mailing Address - Fax:787-763-5977
Practice Address - Street 1:402 AVENIDA MUNOX RIVERA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00919
Practice Address - Country:US
Practice Address - Phone:787-705-8677
Practice Address - Fax:787-763-5977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory