Provider Demographics
NPI:1346970712
Name:MEDICO XPRESO MULTI GROUP LLC
Entity type:Organization
Organization Name:MEDICO XPRESO MULTI GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEYRA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:RIVERA HUREL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-459-5556
Mailing Address - Street 1:688 CALLE MAR DEL NORTE
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4530
Mailing Address - Country:US
Mailing Address - Phone:787-942-3232
Mailing Address - Fax:
Practice Address - Street 1:1790 AV. LAS LOMAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-942-3232
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory