Provider Demographics
NPI:1336136423
Name:LABORATORIO MEDECINA NUCLEAR & PET INC
Entity Type:Organization
Organization Name:LABORATORIO MEDECINA NUCLEAR & PET INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-751-4222
Mailing Address - Street 1:PO BOX 360064
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0064
Mailing Address - Country:US
Mailing Address - Phone:787-751-4222
Mailing Address - Fax:787-751-4180
Practice Address - Street 1:CENTRO CARDIO VASCULAR DE PR Y EL CARIBE
Practice Address - Street 2:1ER PISO ESQUINA A MEDICO MIRANDA ENTRADA PRINCIPAL
Practice Address - City:RIO PIEDRA
Practice Address - State:PR
Practice Address - Zip Code:00924
Practice Address - Country:US
Practice Address - Phone:787-751-4222
Practice Address - Fax:787-751-4180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291900000XLaboratoriesMilitary Clinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
90192Medicare ID - Type Unspecified