Provider Demographics
NPI:1982067773
Name:CORMED LLC
Entity type:Organization
Organization Name:CORMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BANOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-773-1822
Mailing Address - Street 1:PO BOX 194781
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-4781
Mailing Address - Country:US
Mailing Address - Phone:787-773-1822
Mailing Address - Fax:787-793-4495
Practice Address - Street 1:7 METRO OFFICE PARK
Practice Address - Street 2:SUITE 204
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968
Practice Address - Country:US
Practice Address - Phone:787-773-1822
Practice Address - Fax:787-793-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory