Provider Demographics
NPI:1285888529
Name:ALGARIN, MILDRED DEL CARMEN (MT)
Entity type:Individual
Prefix:
First Name:MILDRED
Middle Name:DEL CARMEN
Last Name:ALGARIN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-0455
Mailing Address - Country:US
Mailing Address - Phone:787-862-0500
Mailing Address - Fax:787-862-0500
Practice Address - Street 1:20 CALLE DEL CARMEN
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3062
Practice Address - Country:US
Practice Address - Phone:787-862-0500
Practice Address - Fax:787-862-0500
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3181246QM0706X
PR289291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30861Medicare PIN