Provider Demographics
NPI:1124194527
Name:LABORATORIO BEIRO INC
Entity Type:Organization
Organization Name:LABORATORIO BEIRO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:
Authorized Official - First Name:LORENZO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-864-1866
Mailing Address - Street 1:PO BOX 2878
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-2878
Mailing Address - Country:US
Mailing Address - Phone:787-864-1866
Mailing Address - Fax:787-864-8654
Practice Address - Street 1:CALLE PALMER #22 SUR
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784-2878
Practice Address - Country:US
Practice Address - Phone:787-864-1866
Practice Address - Fax:787-864-8654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR164291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031222Medicaid