1003907346 NPI number — HIGH PROFILE LABORATORIES TESTING SERVICES LLC

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 1003907346 NPI number — HIGH PROFILE LABORATORIES TESTING SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HIGH PROFILE LABORATORIES TESTING SERVICES LLC
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:
Provider Other Organization Name Type Code:
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:
1003907346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB 355 AVE ESMERALDA 405
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00969-4457
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-720-0760
Provider Business Mailing Address Fax Number:
787-720-0763

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 177 AVE LOMAS VERDES
Provider Second Line Business Practice Location Address:
SUITE 103 EDIF PHOENIX CLINICA LOS AMERICAS
Provider Business Practice Location Address City Name:
GUAYNABO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-720-0760
Provider Business Practice Location Address Fax Number:
787-720-0763
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RIPOLL
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
Authorized Official Title or Position:
LABORATORY DIRECTOR
Authorized Official Telephone Number:
787-720-0767

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  1081 , 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)





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