Provider Demographics
NPI:1912188673
Name:VICTORIA PEREZ VELEZ
Entity Type:Organization
Organization Name:VICTORIA PEREZ VELEZ
Other - Org Name:LABORATORIO CLINICO ISABELA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-830-0050
Mailing Address - Street 1:222 RUTA 475 LLANADAS
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4804
Mailing Address - Country:US
Mailing Address - Phone:787-830-0050
Mailing Address - Fax:787-830-0050
Practice Address - Street 1:CARR 474 KM 2.9 GALATEO BAJO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4804
Practice Address - Country:US
Practice Address - Phone:787-830-0050
Practice Address - Fax:787-830-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR30223Medicare PIN