Provider Demographics
NPI:1861827701
Name:ALCIDES OQUENDO SOLIS
Entity Type:Organization
Organization Name:ALCIDES OQUENDO SOLIS
Other - Org Name:LABORATORIO CENTRAL 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALCIDES
Authorized Official - Middle Name:
Authorized Official - Last Name:OQUENDO
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-612-0155
Mailing Address - Street 1:350 AVENIDA FONT MARTELO
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:UM
Mailing Address - Phone:787-612-0155
Mailing Address - Fax:
Practice Address - Street 1:350 AVE FONT MARTELO
Practice Address - Street 2:SUITE 2
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3266
Practice Address - Country:US
Practice Address - Phone:787-612-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR945291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory