Provider Demographics
NPI:1366297582
Name:LATIN CLINICAL TRIAL CENTER
Entity type:Organization
Organization Name:LATIN CLINICAL TRIAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:939-599-3317
Mailing Address - Street 1:PMB 487
Mailing Address - Street 2:PO BOX 70344
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 AVE PONCE DE LEON STE 205205A
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1900
Practice Address - Country:US
Practice Address - Phone:787-209-4914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care