Provider Demographics
NPI:1689726135
Name:ALBA I. RIVERA TORRES
Entity Type:Organization
Organization Name:ALBA I. RIVERA TORRES
Other - Org Name:LABORATORIO CLINICO PLAZA OASIS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALBA
Authorized Official - Middle Name:I
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-845-1508
Mailing Address - Street 1:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0519
Mailing Address - Country:US
Mailing Address - Phone:787-845-1508
Mailing Address - Fax:787-845-1508
Practice Address - Street 1:CARRETERA # 153 KM 6 HM 9
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757
Practice Address - Country:US
Practice Address - Phone:787-845-1508
Practice Address - Fax:787-848-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1067291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
31387Medicare ID - Type Unspecified