Provider Demographics
NPI:1649396862
Name:SERVICIOS MEDICOS LAS MARIAS
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS LAS MARIAS
Other - Org Name:LABORATORIO MARICAO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:IT MANGER
Authorized Official - Prefix:
Authorized Official - First Name:URIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LABOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-827-2230
Mailing Address - Street 1:AVE. LUCCETTI #9
Mailing Address - Street 2:
Mailing Address - City:MARICAO
Mailing Address - State:PR
Mailing Address - Zip Code:00606
Mailing Address - Country:US
Mailing Address - Phone:787-827-2230
Mailing Address - Fax:787-827-4155
Practice Address - Street 1:AVE. LUCCETTI #9
Practice Address - Street 2:
Practice Address - City:MARICAO
Practice Address - State:PR
Practice Address - Zip Code:00606
Practice Address - Country:US
Practice Address - Phone:787-827-2230
Practice Address - Fax:787-827-4155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR903291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherPATRONAL SOCIAL SECURITY