Provider Demographics
NPI:1346250156
Name:LAB. CLINICO BACTERIOLOGICO TORVAL AGOSTINI
Entity Type:Organization
Organization Name:LAB. CLINICO BACTERIOLOGICO TORVAL AGOSTINI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:E
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-739-4090
Mailing Address - Street 1:21 CALLE SANTIAGO R PALMER
Mailing Address - Street 2:
Mailing Address - City:CIDRA
Mailing Address - State:PR
Mailing Address - Zip Code:00739-3323
Mailing Address - Country:US
Mailing Address - Phone:787-739-4090
Mailing Address - Fax:787-739-4090
Practice Address - Street 1:21 CALLE SANTIAGO R PALMER
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3323
Practice Address - Country:US
Practice Address - Phone:787-739-4090
Practice Address - Fax:787-739-4090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0792291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory