Provider Demographics
NPI:1326181363
Name:LABORATORIO LOS PINOS
Entity Type:Organization
Organization Name:LABORATORIO LOS PINOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFONTAINE
Authorized Official - Suffix:
Authorized Official - Credentials:LICENCES
Authorized Official - Phone:787-881-2828
Mailing Address - Street 1:PO BOX 542
Mailing Address - Street 2:
Mailing Address - City:GARROCHALES
Mailing Address - State:PR
Mailing Address - Zip Code:00652-0542
Mailing Address - Country:US
Mailing Address - Phone:787-881-2828
Mailing Address - Fax:787-881-2828
Practice Address - Street 1:EDIF. F. SOTO ZONA INDUSTRIAL
Practice Address - Street 2:CARR.#2 KM.67.7 BO. SANTANA
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-881-2828
Practice Address - Fax:787-881-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1123291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory