Provider Demographics
NPI:1568445880
Name:LABORATORIO CLINICO APRIL GARDENS INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO APRIL GARDENS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NILSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-733-0710
Mailing Address - Street 1:PO BOX 682
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0682
Mailing Address - Country:US
Mailing Address - Phone:787-733-0710
Mailing Address - Fax:787-733-0710
Practice Address - Street 1:RAMAL 917 KM 0 HM 1 BO TEJAS
Practice Address - Street 2:
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771-0000
Practice Address - Country:US
Practice Address - Phone:787-733-0710
Practice Address - Fax:787-733-0750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR885291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
583317183OtherSS
40D0908416OtherCLIA
31117Medicare ID - Type UnspecifiedLIC 885