Provider Demographics
NPI:1326168055
Name:SERVICIOS MEDICOS LAS MARIAS, INC
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS LAS MARIAS, INC
Other - Org Name:LABORATORIO LAS MARIAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-827-2230
Mailing Address - Street 1:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670-0023
Mailing Address - Country:US
Mailing Address - Phone:787-827-2230
Mailing Address - Fax:787-827-4155
Practice Address - Street 1:CARR 119 KM 27.4
Practice Address - Street 2:
Practice Address - City:LAS MARIAS
Practice Address - State:PR
Practice Address - Zip Code:00670
Practice Address - Country:US
Practice Address - Phone:787-827-2230
Practice Address - Fax:787-827-4155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR890291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31383Medicare ID - Type Unspecified