Provider Demographics
NPI:1366500746
Name:MILDRED DEL C ALGARIN AVILES
Entity Type:Organization
Organization Name:MILDRED DEL C ALGARIN AVILES
Other - Org Name:LABORATORIO CLINICO MOROVIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILDRED
Authorized Official - Middle Name:DEL C
Authorized Official - Last Name:ALGARIN
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT
Authorized Official - Phone:787-862-0500
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687
Mailing Address - Country:US
Mailing Address - Phone:787-862-0500
Mailing Address - Fax:787-862-0400
Practice Address - Street 1:CALLE DEL CARMEN #20
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687
Practice Address - Country:US
Practice Address - Phone:787-862-0500
Practice Address - Fax:787-862-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3181291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31041OtherTRIPLE-S PROVIDER NUMBER