Provider Demographics
NPI:1225308083
Name:LABORATORIO CLINICO MANUED INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO MANUED INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM.
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:ANGLERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-285-0684
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-0397
Mailing Address - Country:US
Mailing Address - Phone:787-852-0243
Mailing Address - Fax:787-850-6785
Practice Address - Street 1:56 CALLE DOLORES CABRERA ALONSO E
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4269
Practice Address - Country:US
Practice Address - Phone:787-852-0243
Practice Address - Fax:787-850-6785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR86291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory