Provider Demographics
NPI:1033306139
Name:LABORATORIO CLINICO LLANADAS, INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO LLANADAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZULMA
Authorized Official - Middle Name:RODRIGUEZ
Authorized Official - Last Name:PANTOJA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-846-6323
Mailing Address - Street 1:4 AVE COLON
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-4929
Mailing Address - Country:US
Mailing Address - Phone:787-846-6323
Mailing Address - Fax:787-846-3081
Practice Address - Street 1:AVE 140 LLANADAS MEDICAL PLAZA
Practice Address - Street 2:SUITE 3
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0000
Practice Address - Country:US
Practice Address - Phone:787-846-6323
Practice Address - Fax:787-846-3081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1133291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory