Provider Demographics
NPI:1558938316
Name:LABORATORIO TERESITA
Entity Type:Organization
Organization Name:LABORATORIO TERESITA
Other - Org Name:LABORATORIO TERESITA DORADO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:ZAMARA
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-675-0112
Mailing Address - Street 1:CALLE CUARZO A23 MIRABELLA VILLAGE & CLUB
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-675-0112
Mailing Address - Fax:787-200-8762
Practice Address - Street 1:CALLE MENDEZ VIGO #410 ESQ. CARR. 698
Practice Address - Street 2:LOCAL 205
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4800
Practice Address - Country:US
Practice Address - Phone:787-233-3414
Practice Address - Fax:787-200-8762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-09
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory