Provider Demographics
NPI:1245207265
Name:LABORATORIO RODRIGUEZ,INC.
Entity Type:Organization
Organization Name:LABORATORIO RODRIGUEZ,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:I
Authorized Official - Credentials:MT
Authorized Official - Phone:787-859-3538
Mailing Address - Street 1:CALLE NUEVA 2
Mailing Address - Street 2:
Mailing Address - City:COROZAL
Mailing Address - State:PR
Mailing Address - Zip Code:00783
Mailing Address - Country:US
Mailing Address - Phone:787-859-3538
Mailing Address - Fax:787-859-3538
Practice Address - Street 1:2 CALLE NUEVA
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-1973
Practice Address - Country:US
Practice Address - Phone:787-859-3538
Practice Address - Fax:787-859-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR660291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory