Provider Demographics
NPI:1205278090
Name:MILAB LLC
Entity type:Organization
Organization Name:MILAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTRADA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-632-7638
Mailing Address - Street 1:353 CAMINO LOS LIRIOS
Mailing Address - Street 2:URB SABANERA DEL RIO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-5249
Mailing Address - Country:US
Mailing Address - Phone:787-632-7638
Mailing Address - Fax:787-744-2016
Practice Address - Street 1:CARRETERA 185 KM 12.6
Practice Address - Street 2:BARRIO CEDROS
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-776-2492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR936291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory