Provider Demographics
NPI:1841793213
Name:MT LABORATORIO COTO LAUREL, INC
Entity Type:Organization
Organization Name:MT LABORATORIO COTO LAUREL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIEDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-505-1240
Mailing Address - Street 1:PO BOX 801176
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1176
Mailing Address - Country:US
Mailing Address - Phone:787-691-7527
Mailing Address - Fax:
Practice Address - Street 1:14 CALLE CENTRAL # 99
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780-2112
Practice Address - Country:US
Practice Address - Phone:787-844-5788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory