Provider Demographics
NPI:1699881409
Name:LABORATORIO CLINICO ADJUNTAS
Entity type:Organization
Organization Name:LABORATORIO CLINICO ADJUNTAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:VERA
Authorized Official - Suffix:
Authorized Official - Credentials:4061
Authorized Official - Phone:787-829-6375
Mailing Address - Street 1:33 CALLE SAN JOAQUIN
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-2135
Mailing Address - Country:US
Mailing Address - Phone:787-829-6375
Mailing Address - Fax:787-829-6375
Practice Address - Street 1:33 SAN JOAQUIN ST.
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601
Practice Address - Country:UM
Practice Address - Phone:787-829-6375
Practice Address - Fax:787-829-6375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR503291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory