1174025837 NPI number — LABORATORIO CIMA CAMINO NUEVO, INC.

Table of content: PATRICK JONATHAN TAUS MD, PHD (NPI 1053800474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174025837 NPI number — LABORATORIO CIMA CAMINO NUEVO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CIMA CAMINO NUEVO, INC.
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:
6
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:
1174025837
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 243
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YABUCOA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00767-0243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-266-5544
Provider Business Mailing Address Fax Number:
787-893-1839

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 901 KM 3 HM 6
Provider Second Line Business Practice Location Address:
BO CAMINO NUEVO
Provider Business Practice Location Address City Name:
YABUCOA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00767-0243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-266-5544
Provider Business Practice Location Address Fax Number:
787-893-1839
Provider Enumeration Date:
03/08/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CINTRON MALDONADO
Authorized Official First Name:
JUAN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENTE
Authorized Official Telephone Number:
787-893-5544

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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