Provider Demographics
NPI:1255420063
Name:LABORATORIO CLINICO CAMUY
Entity type:Organization
Organization Name:LABORATORIO CLINICO CAMUY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS FIGUEROA
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-898-5645
Mailing Address - Street 1:4 CALLE INFANZON
Mailing Address - Street 2:
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-2627
Mailing Address - Country:US
Mailing Address - Phone:787-898-5645
Mailing Address - Fax:787-898-5645
Practice Address - Street 1:4 CALLE INFANZON
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627-2627
Practice Address - Country:US
Practice Address - Phone:787-898-5645
Practice Address - Fax:787-898-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR444291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031039Medicare ID - Type Unspecified