Provider Demographics
NPI:1619968559
Name:LABORATORIO FERAM INC
Entity Type:Organization
Organization Name:LABORATORIO FERAM INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MT ASCP
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-735-8686
Mailing Address - Street 1:CALLE RAMON FLORES NUM 65
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1317
Mailing Address - Country:US
Mailing Address - Phone:787-735-8686
Mailing Address - Fax:787-735-3112
Practice Address - Street 1:CALLE RAMON FLORES NUM 65
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-1317
Practice Address - Country:US
Practice Address - Phone:787-735-8686
Practice Address - Fax:787-735-3112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR038172Medicare ID - Type Unspecified