Provider Demographics
NPI:1245298736
Name:LABORATORIO CLINICO PAOLI, INC
Entity type:Organization
Organization Name:LABORATORIO CLINICO PAOLI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARMIBELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAOLI GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-863-9090
Mailing Address - Street 1:PO BOX 1181
Mailing Address - Street 2:
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-1181
Mailing Address - Country:US
Mailing Address - Phone:787-863-9090
Mailing Address - Fax:787-863-3257
Practice Address - Street 1:10 UNION ST.
Practice Address - Street 2:FAJARDO MEDICAL PLAZA SUITE 101
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-1181
Practice Address - Country:US
Practice Address - Phone:787-863-9090
Practice Address - Fax:787-863-3257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR218291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory