Provider Demographics
NPI:1881661114
Name:TILIA,INC.
Entity Type:Organization
Organization Name:TILIA,INC.
Other - Org Name:LABORATORIO CLINICO LAS AMERICAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ILIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT
Authorized Official - Phone:787-753-7155
Mailing Address - Street 1:400 AVE DOMENECH
Mailing Address - Street 2:LAS AMERICAS PROFESSIONAL CENTER
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3710
Mailing Address - Country:US
Mailing Address - Phone:787-753-7155
Mailing Address - Fax:787-753-7756
Practice Address - Street 1:400 AVE DOMENECH
Practice Address - Street 2:LAS AMERICAS PROFESSIONAL CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3710
Practice Address - Country:US
Practice Address - Phone:787-753-7155
Practice Address - Fax:787-753-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR118291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31452Medicare ID - Type Unspecified