Provider Demographics
NPI:1639127723
Name:LUIS ALONSO & CO INC
Entity Type:Organization
Organization Name:LUIS ALONSO & CO INC
Other - Org Name:LABORATORIO CLINICO SANTA MARIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-844-4774
Mailing Address - Street 1:CALLE FERROCARRIL SANTA MARIA MEDICAL BUILDING
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-844-4774
Mailing Address - Fax:787-813-5781
Practice Address - Street 1:CALLE FERROCARRIL SANTA MARIA MEDICAL BUILDING
Practice Address - Street 2:SUITE 103
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-844-4774
Practice Address - Fax:787-813-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR751291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031690Medicare PIN