Provider Demographics
NPI:1467879445
Name:SERVICIOS DE SALUD LA MORENITA INC
Entity Type:Organization
Organization Name:SERVICIOS DE SALUD LA MORENITA INC
Other - Org Name:LABORATORIO CLINICO LA MORENITA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EFRAIN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-637-4416
Mailing Address - Street 1:2020 VIA CARACOLES
Mailing Address - Street 2:URB. CAMINO DEL MAR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4369
Mailing Address - Country:US
Mailing Address - Phone:787-785-5050
Mailing Address - Fax:787-785-5050
Practice Address - Street 1:PR 174 KM 10.2
Practice Address - Street 2:BARRIO GUARAGUAO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-785-5050
Practice Address - Fax:787-785-5050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory