Provider Demographics
NPI:1851446611
Name:JANICE DEL C ROLON MARRERO
Entity Type:Organization
Organization Name:JANICE DEL C ROLON MARRERO
Other - Org Name:LABORATORIO CLINICO ROLMAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNERS
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-735-6584
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705
Mailing Address - Country:US
Mailing Address - Phone:787-735-6584
Mailing Address - Fax:787-735-6584
Practice Address - Street 1:LAB CLINICO ROLMAR EDIFICIO GUAYACANER PISO
Practice Address - Street 2:SUITE 106
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705
Practice Address - Country:US
Practice Address - Phone:787-735-6584
Practice Address - Fax:787-735-6584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3152291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0030987Medicare PIN