Provider Demographics
NPI:1083050157
Name:HDT,CORP.
Entity Type:Organization
Organization Name:HDT,CORP.
Other - Org Name:LABORATORIO CLINICO Y BACTERIOLOGICO VIOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AINEX
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MTASCP
Authorized Official - Phone:787-891-3953
Mailing Address - Street 1:CALLE 22 DE JUNIO 123
Mailing Address - Street 2:
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-891-3953
Mailing Address - Fax:
Practice Address - Street 1:CALLE BETANCES 15
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-3953
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HDT,CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR467291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038335OtherMEDICARE ID-