Provider Demographics
NPI:1265514111
Name:POLYSOMNOGRAPHY & MULTIPLE TESTING SERVICES
Entity type:Organization
Organization Name:POLYSOMNOGRAPHY & MULTIPLE TESTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GILBERTO
Authorized Official - Middle Name:MONRIOG
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CRT
Authorized Official - Phone:787-856-1000
Mailing Address - Street 1:CARR. 128 KM. 2.1
Mailing Address - Street 2:HOSPITAL METROPOLITANO DR. TITO MATTEI SUITE 105
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-856-1000
Mailing Address - Fax:787-856-1000
Practice Address - Street 1:CARR. 128 KM. 2.1
Practice Address - Street 2:HOSPITAL METROPOLITANO DR. TITO MATTEI SUITE 105
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-856-1000
Practice Address - Fax:787-856-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory