Provider Demographics
NPI:1215104849
Name:METRO EAST BLOOD SERVICE
Entity type:Organization
Organization Name:METRO EAST BLOOD SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-487-9328
Mailing Address - Street 1:1626 CALLE ALICANTE
Mailing Address - Street 2:URB BAHIA VISTAMAR
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983-1470
Mailing Address - Country:US
Mailing Address - Phone:787-762-3240
Mailing Address - Fax:787-762-3240
Practice Address - Street 1:BLOQUE 30-A AVE ROBERTO CLEMENTE
Practice Address - Street 2:URB VILLA CAROLINA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-1470
Practice Address - Country:US
Practice Address - Phone:787-757-0570
Practice Address - Fax:787-762-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9847331L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes331L00000XSuppliersBlood Bank
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR9847OtherCELL SAVER AUTOLOGOUS BLOOD