Provider Demographics
NPI:1154482909
Name:SANDRA L. AMADOR PEREZ
Entity Type:Organization
Organization Name:SANDRA L. AMADOR PEREZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LINETTE
Authorized Official - Last Name:AMADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-897-2439
Mailing Address - Street 1:PO BOX 743
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0743
Mailing Address - Country:US
Mailing Address - Phone:787-897-2430
Mailing Address - Fax:787-897-2439
Practice Address - Street 1:7 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669-2421
Practice Address - Country:US
Practice Address - Phone:787-897-2439
Practice Address - Fax:787-897-2439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory