Provider Demographics
NPI:1629075098
Name:LABORATORIO CLINICO ROSA E ORTIZ,P.S.C.
Entity Type:Organization
Organization Name:LABORATORIO CLINICO ROSA E ORTIZ,P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ORTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-267-8202
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0116
Mailing Address - Country:US
Mailing Address - Phone:787-267-8202
Mailing Address - Fax:787-267-8202
Practice Address - Street 1:13A CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-3654
Practice Address - Country:US
Practice Address - Phone:787-267-8202
Practice Address - Fax:787-267-8202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00455291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory