Provider Demographics
NPI:1326020678
Name:NANCY E WILLIAMS MALTES
Entity Type:Organization
Organization Name:NANCY E WILLIAMS MALTES
Other - Org Name:LABORATORIO CLINICO WILLIAMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS MALTES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-848-0405
Mailing Address - Street 1:PO BOX 10038
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0038
Mailing Address - Country:US
Mailing Address - Phone:787-848-0405
Mailing Address - Fax:787-290-3535
Practice Address - Street 1:1128 AVE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-0643
Practice Address - Country:US
Practice Address - Phone:787-848-0405
Practice Address - Fax:787-290-3535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-14
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR704291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30579OtherSSS
PR660429616OtherFIRST PLUS ADVANCE
PR583940508OtherMAPFRE
PR051300OtherCRUZ AZUL
PR39893OtherASOCIACION DE MAESTROS
PR7310078OtherHUMANA
PR400305OtherPREFERRED HEALTH PLAN
PR800218OtherMMM
PR3099OtherIMC
PR583940508OtherMCS
PR660429616OtherFIRST PLUS ADVANCE
PR=========OtherBLUECROSS BLUE
PR400305OtherPREFERRED HEALTH PLAN
PR800218OtherMMM
PR660429616OtherFIRST PLUS ADVANCE