1164629341 NPI number — LABORATORIO TORRES ANTOMMATTEI

Table of content: (NPI 1164629341)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164629341 NPI number — LABORATORIO TORRES ANTOMMATTEI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO TORRES ANTOMMATTEI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ARMANDO X.TORRES-ANTOMMATTEI
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164629341
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 441
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YAUCO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00698-0441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-856-4005
Provider Business Mailing Address Fax Number:
787-856-4005

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
52 CALLE MATTEI LLUBERAS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698-3666
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-856-4005
Provider Business Practice Location Address Fax Number:
787-856-4005
Provider Enumeration Date:
06/29/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TORRES-ANTOMMATTEI
Authorized Official First Name:
ARMANDO
Authorized Official Middle Name:
X
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
787-856-4005

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  614 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)