Provider Demographics
NPI:1326019928
Name:WILFREDO REYES LABRADOR
Entity Type:Organization
Organization Name:WILFREDO REYES LABRADOR
Other - Org Name:LABORATORIO CLINICO WILMAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:E
Authorized Official - Last Name:GRAJALES
Authorized Official - Suffix:
Authorized Official - Credentials:BS-MT-ASCP
Authorized Official - Phone:787-667-1902
Mailing Address - Street 1:PO BOX 3386
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-3386
Mailing Address - Country:US
Mailing Address - Phone:787-757-1040
Mailing Address - Fax:787-757-1040
Practice Address - Street 1:PISO 6, OFIC 312,
Practice Address - Street 2:CAROLINA SHOPPING COURT
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-757-1040
Practice Address - Fax:787-757-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR236291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRITINOtherMCS & MCS REFORMA
PRLA0351OtherPALIC-PANAMERICAN LIFE
PR800219OtherMEDICARE Y MUCHO MAS- MMM
PR20024OtherAMERICAN HEALTH
PR51652OtherCRUZ AZUL
PRITINOtherMAPFRE & MAPFRE MEDICARE
PR1100105OtherHUMANA
PR30955OtherMEDICARE OPTIMO
PR30955OtherSSS & SSS REFORMA
PR8397OtherFIRST MEDICAL- IMC
PRITINOtherCIGNA & CIGNA EXCLUSIVE
PR20408OtherPREFERRED MEDICARE CHOICE
PR6007449OtherACAA
PRITINOtherOPTION HEALTHCARE
PR11236OtherGLOBAL HEALTH
PR400337OtherUTI- PREFFERED HEALTH
PR20024OtherAMERICAN HEALTH