1588157754 NPI number — LABORATORIO CLINICO BACTERIOLOGICO SAN ANTONIO II INC

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 1588157754 NPI number — LABORATORIO CLINICO BACTERIOLOGICO SAN ANTONIO II INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO BACTERIOLOGICO SAN ANTONIO II 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:
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:
1588157754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 791
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00690-0791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-431-1188
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2071 AVE PEDRO ALBIZU CAMPOS
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-890-5454
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/12/2018

Additional Information

Authorized Official

Authorized Official Last Name:
CRESPO
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
LOUISA
Authorized Official Title or Position:
LAB DIRECTOR
Authorized Official Telephone Number:
787-890-6161

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)





Copyright © 2007-2025 www.npivalidator.com