Provider Demographics
NPI:1154864353
Name:EMPRESAS MORENO REYES INC.
Entity Type:Organization
Organization Name:EMPRESAS MORENO REYES INC.
Other - Org Name:LABORATORIO PERLA DEL PLATA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-875-3932
Mailing Address - Street 1:RR 11 BOX 5470
Mailing Address - Street 2:BO NUEVO
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-875-3932
Mailing Address - Fax:787-875-3965
Practice Address - Street 1:CARR 156 KM 35.4
Practice Address - Street 2:BO DONA ELENA SECTOR LA GALLERA
Practice Address - City:COMERIO
Practice Address - State:PR
Practice Address - Zip Code:00782
Practice Address - Country:US
Practice Address - Phone:787-875-3932
Practice Address - Fax:787-875-3965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1350291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory