Provider Demographics
NPI:1083609556
Name:IRMARIL PEREZ SANTONI
Entity Type:Organization
Organization Name:IRMARIL PEREZ SANTONI
Other - Org Name:LABORATORIO CLINICO YESMAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRMARIL
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-868-2450
Mailing Address - Street 1:CALLE COLON 118
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00602
Mailing Address - Country:UM
Mailing Address - Phone:787-868-2450
Mailing Address - Fax:
Practice Address - Street 1:178 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3222
Practice Address - Country:US
Practice Address - Phone:787-868-2450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-12
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR814291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30042Medicare PIN