Provider Demographics
NPI:1588730923
Name:LABORATORIO CLINICO DEL PARQUE INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO DEL PARQUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIRALDO
Authorized Official - Suffix:
Authorized Official - Credentials:TECNOLOGO MEDICO
Authorized Official - Phone:787-724-4161
Mailing Address - Street 1:PO BOX 41028
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00940-1028
Mailing Address - Country:US
Mailing Address - Phone:787-724-4161
Mailing Address - Fax:787-724-4161
Practice Address - Street 1:352 CALLE DEL PARQUE
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3702
Practice Address - Country:US
Practice Address - Phone:787-724-4161
Practice Address - Fax:787-724-4161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
20137OtherAMERICAN HEALTH INC
660491943OtherAMERICAN HEALTH MEDICARE
9090086OtherHUMANA HMO POS MEDICAL
660491943OtherHUMANA GOLD CHOICE
660491943OtherMEDICAL CARD SYSTEM REFOR
660491943OtherOPTION HEALTH CARE NETWOR
9090086OtherHUMANA HEALTH PLAN OF PR
051667OtherLA CRUZ AZUL DE PUERTO RI
660491943OtherCOSVIMED
660491943OtherCIGNA PROVIDER SERVICES
660491943OtherMAPFRE EXCEL
LA037OtherPAN AMERICAN LIFE INS CO
660491943OtherMCS CLASSICARE
660491943OtherMEDICAL CARD SYSTEM
800464OtherMMM HEALTHCARE
400322OtherPREFERRED
660491943OtherINTERNATIONAL MEDICAL CAR
660491943OtherMAPFRE LIFE
660491943OtherPALIC PROVIDER NETWORK
660491943OtherMCS CLASSICARE