1265421119 NPI number — VILMA I PADILLA PADILLA/LAB CLINICO ROYAL GARDENS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265421119 NPI number — VILMA I PADILLA PADILLA/LAB CLINICO ROYAL GARDENS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILMA I PADILLA PADILLA/LAB CLINICO ROYAL GARDENS
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:
VILMA I PADILLA PADILLA/LAB CLINICO ROYAL GARDENS
Provider Other Organization Name Type Code:
4
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:
1265421119
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE ESTHER E-4 ROYAL GARDENS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00957
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-279-4446
Provider Business Mailing Address Fax Number:
787-279-6428

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE ESTHER E-4 ROYAL GARDENS
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-279-4446
Provider Business Practice Location Address Fax Number:
787-279-6428
Provider Enumeration Date:
10/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PADILLA
Authorized Official First Name:
VILMA
Authorized Official Middle Name:
PADILLA
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
787-279-4446

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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