Provider Demographics
NPI:1386233799
Name:LABORATORIO LARACUENTE LLC
Entity type:Organization
Organization Name:LABORATORIO LARACUENTE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARACUENTE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-796-1003
Mailing Address - Street 1:291 CALLE MENDEZ VIGO
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4913
Mailing Address - Country:US
Mailing Address - Phone:787-796-1003
Mailing Address - Fax:
Practice Address - Street 1:291 CALLE MENDEZ VIGO
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4913
Practice Address - Country:US
Practice Address - Phone:787-796-1003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory