Provider Demographics
NPI:1184841496
Name:MUNICIPIO DE MANATI
Entity Type:Organization
Organization Name:MUNICIPIO DE MANATI
Other - Org Name:CENTRO DE DIAGNOSTICO Y TRATAMIENTO
Other - Org Type:Other Name
Authorized Official - Title/Position:ALCALDE
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:AUBIN
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-854-2292
Mailing Address - Street 1:CALLE QUINONES #10
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-854-2292
Mailing Address - Fax:787-854-2092
Practice Address - Street 1:CARR. #2 KM 50
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-2292
Practice Address - Fax:787-854-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31022Medicare PIN