1558534099 NPI number — LABORATORIO CLINICO ANIBEL

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 1558534099 NPI number — LABORATORIO CLINICO ANIBEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO ANIBEL
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:
1558534099
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 CALLE YAGUEZ
Provider Second Line Business Mailing Address:
ESTANCIAS DEL RIO
Provider Business Mailing Address City Name:
AGUAS BUENAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00703-9620
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-767-4694
Provider Business Mailing Address Fax Number:
787-763-4347

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
724 AVE PONCE DE LEON
Provider Second Line Business Practice Location Address:
HATO REY
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-4512
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-4694
Provider Business Practice Location Address Fax Number:
787-763-4347
Provider Enumeration Date:
04/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
TORRES
Authorized Official First Name:
MARIBEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR/OWNER
Authorized Official Telephone Number:
787-767-4694

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  0268 , 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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