Provider Demographics
NPI:1427046226
Name:SARA J TORO
Entity type:Organization
Organization Name:SARA J TORO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DUENA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORO
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-840-9779
Mailing Address - Street 1:1255 PASEO LAS MONJITAS
Mailing Address - Street 2:STE 119
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4220
Mailing Address - Country:US
Mailing Address - Phone:787-840-9779
Mailing Address - Fax:787-842-9162
Practice Address - Street 1:1255 PASEO LAS MONJITAS
Practice Address - Street 2:STE 119
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4220
Practice Address - Country:US
Practice Address - Phone:787-840-9779
Practice Address - Fax:787-842-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR908291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31156Medicare ID - Type Unspecified