Provider Demographics
NPI:1376136069
Name:QUEST DIAGNOSTICS OF PUERTO RICO, INC
Entity Type:Organization
Organization Name:QUEST DIAGNOSTICS OF PUERTO RICO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OMAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPINOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-474-2900
Mailing Address - Street 1:107 AVE ORTEGON STE 103
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2516
Mailing Address - Country:US
Mailing Address - Phone:787-474-2900
Mailing Address - Fax:787-765-5663
Practice Address - Street 1:85 CALLE DON CHEMARY
Practice Address - Street 2:
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676-4120
Practice Address - Country:US
Practice Address - Phone:787-474-2900
Practice Address - Fax:787-765-5663
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:QUEST DIAGNOSTICS OF PUERTO RICO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory