Provider Demographics
NPI:1437180445
Name:LABORATORIO CLINICO DR. LOPEZ PINTO INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO DR. LOPEZ PINTO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLIN. & ANAT. PATH. / LAB. DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:MARIO
Authorized Official - Last Name:LOPEZ PINTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-854-5660
Mailing Address - Street 1:PO BOX 1158
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1158
Mailing Address - Country:US
Mailing Address - Phone:787-854-5560
Mailing Address - Fax:787-884-0084
Practice Address - Street 1:MANATI MEDICAL PLZ
Practice Address - Street 2:SUITE 102 JOSE CANDELAS STREET #1
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5507
Practice Address - Country:US
Practice Address - Phone:787-854-5660
Practice Address - Fax:787-884-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR684291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038126Medicare ID - Type Unspecified
PRD08518Medicare UPIN