Provider Demographics
NPI:1619428067
Name:CLINICA YAGUEZ INC
Entity Type:Organization
Organization Name:CLINICA YAGUEZ INC
Other - Org Name:LABORATORIO CLINICO EL MANI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:I
Authorized Official - Last Name:HUERTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-832-8445
Mailing Address - Street 1:CARRETERA 64 KM 37
Mailing Address - Street 2:BARIO MANI
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-832-8445
Mailing Address - Fax:787-805-2840
Practice Address - Street 1:CARRETERA 64 KM 37
Practice Address - Street 2:BARIO MANI
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-832-8445
Practice Address - Fax:787-805-2840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory