Provider Demographics
NPI:1528188257
Name:SERVICIOS MEDICOS LAS MARIAS
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS LAS MARIAS
Other - Org Name:LABORATORIO CLINICO LAJAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENTE FINANZAS
Authorized Official - Prefix:
Authorized Official - First Name:SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:787-827-2230
Mailing Address - Street 1:P.O. BOX 23
Mailing Address - Street 2:
Mailing Address - City:LAS MARIAS
Mailing Address - State:PR
Mailing Address - Zip Code:00670
Mailing Address - Country:US
Mailing Address - Phone:787-827-2230
Mailing Address - Fax:787-827-4155
Practice Address - Street 1:AVE. FLAMBOYAN NO. 237
Practice Address - Street 2:
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667
Practice Address - Country:US
Practice Address - Phone:787-899-4242
Practice Address - Fax:787-899-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR816291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31382Medicare ID - Type Unspecified