Provider Demographics
NPI:1245407527
Name:NIMAR V & M, INC
Entity Type:Organization
Organization Name:NIMAR V & M, INC
Other - Org Name:AMELIA CLINICAL LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:V
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL TECHNOLOGIST
Authorized Official - Phone:787-644-8215
Mailing Address - Street 1:624 CARR 8860 APT 2603
Mailing Address - Street 2:CAMINO DE LA REINA
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-5444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:59 AVE PONCE DE LEON
Practice Address - Street 2:BO AMELIA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00965-5618
Practice Address - Country:US
Practice Address - Phone:787-644-8215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory