Provider Demographics
NPI:1437318664
Name:FRANCO GINORIO, DAWILMAR (MT)
Entity Type:Individual
Prefix:
First Name:DAWILMAR
Middle Name:
Last Name:FRANCO GINORIO
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:LABORATORIO
Other - Middle Name:CLINICO
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:71 CALLE PH HERNANDEZ
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-2007
Mailing Address - Country:US
Mailing Address - Phone:787-898-4020
Mailing Address - Fax:787-820-5927
Practice Address - Street 1:71 CALLE PH HERNANDEZ
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-2007
Practice Address - Country:US
Practice Address - Phone:787-898-4020
Practice Address - Fax:787-820-5927
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR769291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038326Medicare PIN