Provider Demographics
NPI:1144517988
Name:LABORATORIO OCEAN FRONT INC
Entity type:Organization
Organization Name:LABORATORIO OCEAN FRONT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-807-0007
Mailing Address - Street 1:PO BOX 2221
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-2221
Mailing Address - Country:US
Mailing Address - Phone:787-807-0007
Mailing Address - Fax:
Practice Address - Street 1:5 CARR 686 # KM
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3270
Practice Address - Country:US
Practice Address - Phone:787-807-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABORATORIO CLINICO DEL MAR INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1217291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory