Provider Demographics
NPI:1053481416
Name:LABORATORIO ACROPOLIS INC
Entity Type:Organization
Organization Name:LABORATORIO ACROPOLIS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:DE LOS A
Authorized Official - Last Name:CORTES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-854-3070
Mailing Address - Street 1:PMB 200 P.O. BOX 30500
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-3070
Mailing Address - Fax:787-854-2820
Practice Address - Street 1:STREET D 6 URB. VILLA BEATRIZ
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-3070
Practice Address - Fax:787-854-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031478Medicare PIN