Provider Demographics
NPI:1184249690
Name:LABORATORIO CLINICO CIUDADELA INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO CIUDADELA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:NILSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-287-0650
Mailing Address - Street 1:35 CALE JUAN C BORBON STE 69
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-287-0650
Mailing Address - Fax:
Practice Address - Street 1:CUIDADELA
Practice Address - Street 2:AVENIDA PONCE DE LEON 1511
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00908
Practice Address - Country:US
Practice Address - Phone:787-287-0650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory