Provider Demographics
NPI:1073657854
Name:WHITE BIGIO INC.
Entity Type:Organization
Organization Name:WHITE BIGIO INC.
Other - Org Name:LABORATORIO CLINICO LA FUENTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:R
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-866-6470
Mailing Address - Street 1:AVE 54 KM .9 LA FUENTE TOWN CENTER
Mailing Address - Street 2:APTDO. 11108
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-866-6470
Mailing Address - Fax:787-866-6471
Practice Address - Street 1:AVE 54 KM .9 LA FUENTE TOWN CENTER
Practice Address - Street 2:APTDO. 11108
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-6470
Practice Address - Fax:787-866-6471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1075291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory