Provider Demographics
NPI:1932684438
Name:LABORATORIO JOMYR II, INC.
Entity Type:Organization
Organization Name:LABORATORIO JOMYR II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MYRNALI
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-777-0773
Mailing Address - Street 1:425 CARR. 693 PMB 212
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-306-5510
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE ROSANTA AULET
Practice Address - Street 2:
Practice Address - City:JAYUYA
Practice Address - State:PR
Practice Address - Zip Code:00664-1328
Practice Address - Country:US
Practice Address - Phone:787-306-5510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1197OtherLABORATORY LICENCE