Provider Demographics
NPI:1083095350
Name:LABORATORIO CLINICO PUNTA DIAMANTE
Entity Type:Organization
Organization Name:LABORATORIO CLINICO PUNTA DIAMANTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALBETTE
Authorized Official - Middle Name:F
Authorized Official - Last Name:MARTINEZ SEMIDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MLS ASCP
Authorized Official - Phone:787-604-5186
Mailing Address - Street 1:C12 CALLE 4
Mailing Address - Street 2:COLINAS DE SAN MARTIN
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-2025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:B4 CALLE QUETZAL
Practice Address - Street 2:BO CANAS SECTOR PUNTA DIAMANTE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-604-5186
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory