Provider Demographics
NPI:1164629341
Name:LABORATORIO TORRES ANTOMMATTEI
Entity Type:Organization
Organization Name:LABORATORIO TORRES ANTOMMATTEI
Other - Org Name:ARMANDO X.TORRES-ANTOMMATTEI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:X
Authorized Official - Last Name:TORRES-ANTOMMATTEI
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-856-4005
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0441
Mailing Address - Country:US
Mailing Address - Phone:787-856-4005
Mailing Address - Fax:787-856-4005
Practice Address - Street 1:52 CALLE MATTEI LLUBERAS
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3666
Practice Address - Country:US
Practice Address - Phone:787-856-4005
Practice Address - Fax:787-856-4005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-29
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR614291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30761Medicare ID - Type Unspecified