Provider Demographics
NPI:1730352634
Name:LABORATORIO CLINICO DELGADO AMADOR, PSC
Entity type:Organization
Organization Name:LABORATORIO CLINICO DELGADO AMADOR, PSC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAHUDY
Authorized Official - Middle Name:MARGARITA
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:MS MT ASCP
Authorized Official - Phone:787-376-5524
Mailing Address - Street 1:47 URB VISTA VERDE
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-3302
Mailing Address - Country:US
Mailing Address - Phone:787-820-4722
Mailing Address - Fax:787-898-0318
Practice Address - Street 1:CARR #2 KM 92.9 MARGINAL
Practice Address - Street 2:BARRIO MEMBRILLO
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-820-4722
Practice Address - Fax:787-898-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR798291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory