Provider Demographics
NPI:1073959235
Name:JEANNETTE S. TROCHE
Entity Type:Organization
Organization Name:JEANNETTE S. TROCHE
Other - Org Name:LABORATORIO CLINICO LA MONSERRATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:SARAHI
Authorized Official - Last Name:TROCHE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-378-0653
Mailing Address - Street 1:PO BOX 1338
Mailing Address - Street 2:
Mailing Address - City:HORMIGUEROS
Mailing Address - State:PR
Mailing Address - Zip Code:00660-5338
Mailing Address - Country:US
Mailing Address - Phone:787-378-0653
Mailing Address - Fax:
Practice Address - Street 1:345 CALLE RAMON EMETERIO BETANCES
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-378-0653
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1280291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR40D2054127OtherCLIA ID NUMBER