Provider Demographics
NPI:1407817372
Name:MARIA V BERRIOS
Entity Type:Organization
Organization Name:MARIA V BERRIOS
Other - Org Name:LABORATORIO CLINICO DE LOIZA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL TECHNOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-876-8536
Mailing Address - Street 1:PO BOX 10050
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-0050
Mailing Address - Country:US
Mailing Address - Phone:787-876-8536
Mailing Address - Fax:787-876-8536
Practice Address - Street 1:D6 CALLE 2
Practice Address - Street 2:VILLAS DE LOIZA
Practice Address - City:CANOVANAS
Practice Address - State:PR
Practice Address - Zip Code:00729-4220
Practice Address - Country:US
Practice Address - Phone:787-876-8536
Practice Address - Fax:787-876-8536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR700291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038304Medicare PIN