Provider Demographics
NPI:1184991523
Name:LABORATORIO CLINICO PORTA CARIBE INC.
Entity type:Organization
Organization Name:LABORATORIO CLINICO PORTA CARIBE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUIRRE
Authorized Official - Suffix:
Authorized Official - Credentials:MT(ASCP)
Authorized Official - Phone:787-608-6854
Mailing Address - Street 1:20 CALLE RUIZ BELVIS
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2670
Mailing Address - Country:US
Mailing Address - Phone:787-608-6854
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 153 KM 7.5
Practice Address - Street 2:SECTOR USERAS, BARRIO PASO SECO
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-608-6854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory