Provider Demographics
NPI:1275762361
Name:ILIANA RUIZ
Entity Type:Organization
Organization Name:ILIANA RUIZ
Other - Org Name:LABORATORIO CLINICO DEL ATLANTICO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ILIANA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-878-9833
Mailing Address - Street 1:860 AVE MIRAMAR
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-2724
Mailing Address - Country:US
Mailing Address - Phone:787-878-9833
Mailing Address - Fax:
Practice Address - Street 1:860 AVE MIRAMAR
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2724
Practice Address - Country:US
Practice Address - Phone:787-878-9833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory