Provider Demographics
NPI:1881039402
Name:LABORATORIO MENDOZA, INC
Entity Type:Organization
Organization Name:LABORATORIO MENDOZA, INC
Other - Org Name:LABORATORIO CLINICO MENDOZA
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FLORENCIO
Authorized Official - Middle Name:D
Authorized Official - Last Name:SAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-607-4686
Mailing Address - Street 1:325 CALLE INTERAMERICANA
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4011
Mailing Address - Country:US
Mailing Address - Phone:787-607-4686
Mailing Address - Fax:
Practice Address - Street 1:ROAD 184 KM 31.9
Practice Address - Street 2:BO GUAVATE
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-607-4686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory