1972541324 NPI number — LABORATORIO CLINICO MARIELYS, INC

Table of content: MRS. DEANNA FUGATE WARZEL DPH (NPI 1922250786)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972541324 NPI number — LABORATORIO CLINICO MARIELYS, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO CLINICO MARIELYS, 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:
1972541324
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 3310
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00958-0310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-787-8800
Provider Business Mailing Address Fax Number:
787-786-0883

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
E-29 AVE HERMANAS DAVILA
Provider Second Line Business Practice Location Address:
URB SAN FERNANDO
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00957-2202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-8800
Provider Business Practice Location Address Fax Number:
787-786-0883
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HERNANDEZ
Authorized Official First Name:
MARIA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-787-8800

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  0489 , 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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