Provider Demographics
NPI:1770817678
Name:LABORATORIO CLINICO BEATRIZ INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO BEATRIZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIERRA MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-434-0288
Mailing Address - Street 1:PO BOX 59
Mailing Address - Street 2:PO BOX 59
Mailing Address - City:CIDRA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00739
Mailing Address - Country:UM
Mailing Address - Phone:787-434-0288
Mailing Address - Fax:787-434-0288
Practice Address - Street 1:CARR. 787 KM 4.7
Practice Address - Street 2:BO. BAYAMON
Practice Address - City:CIDRA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00739
Practice Address - Country:UM
Practice Address - Phone:787-434-0288
Practice Address - Fax:787-434-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory