Provider Demographics
NPI:1497044903
Name:LABORATORIO CLINICO ACROPOLIS DE CIALES INC.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO ACROPOLIS DE CIALES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-917-0481
Mailing Address - Street 1:PMB 200 P.O. BOX 30500
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674
Mailing Address - Country:US
Mailing Address - Phone:787-917-0481
Mailing Address - Fax:787-854-2820
Practice Address - Street 1:CARR. PR-149, KM 17.9 BO. PESAS
Practice Address - Street 2:SECTOR BELLA VISTA
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638
Practice Address - Country:US
Practice Address - Phone:787-917-0481
Practice Address - Fax:787-854-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1211291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory