1598724155 NPI number — LAB CLINICO UMPIERRE

Table of content: MARIKA ELINA ESKOLA RNFA (NPI 1104017987)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598724155 NPI number — LAB CLINICO UMPIERRE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAB CLINICO UMPIERRE
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:
1598724155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 364367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-4367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-728-3015
Provider Business Mailing Address Fax Number:
787-727-5574

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 AVE PONCE DE LEON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909-1900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-728-3015
Provider Business Practice Location Address Fax Number:
787-727-5574
Provider Enumeration Date:
03/22/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOLTERO
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
MILTON
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
787-726-0440

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)