Provider Demographics
NPI:1518082809
Name:LABORATORIO CLINICO AYMAT
Entity Type:Organization
Organization Name:LABORATORIO CLINICO AYMAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:R
Authorized Official - Last Name:AYMAT
Authorized Official - Suffix:
Authorized Official - Credentials:M T 2522
Authorized Official - Phone:787-788-2051
Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:CATANO
Mailing Address - State:PR
Mailing Address - Zip Code:00963-1119
Mailing Address - Country:US
Mailing Address - Phone:787-788-2051
Mailing Address - Fax:787-788-6150
Practice Address - Street 1:52 CALLE TREN
Practice Address - Street 2:
Practice Address - City:CATANO
Practice Address - State:PR
Practice Address - Zip Code:00962-4874
Practice Address - Country:US
Practice Address - Phone:787-788-2051
Practice Address - Fax:787-788-6150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR607291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30444Medicare PIN