Provider Demographics
NPI:1629248265
Name:TORO, SARA (LCDA)
Entity Type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:TORO
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 PASEO LAS MONJITAS
Mailing Address - Street 2:STE 119
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4221
Mailing Address - Country:US
Mailing Address - Phone:787-840-9779
Mailing Address - Fax:787-842-9162
Practice Address - Street 1:1255 PASEO LAS MONJITAS
Practice Address - Street 2:STE 119
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4221
Practice Address - Country:US
Practice Address - Phone:787-840-9779
Practice Address - Fax:787-842-9162
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR908291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031156Medicare PIN