Provider Demographics
NPI:1790725109
Name:GARLAND, NILDA ANA (BS MT (ASCP))
Entity Type:Individual
Prefix:MRS
First Name:NILDA
Middle Name:ANA
Last Name:GARLAND
Suffix:
Gender:F
Credentials:BS MT (ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 500
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-825-0616
Mailing Address - Fax:787-825-0616
Practice Address - Street 1:CARR 14 KM 26.9
Practice Address - Street 2:BO. LOS LLANOS
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-825-0616
Practice Address - Fax:787-825-0616
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2354246Z00000X
PR946291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
31329Medicare ID - Type Unspecified