Provider Demographics
NPI:1336177013
Name:LABORATORIO NUCLEAR METROPOLITANO INC
Entity Type:Organization
Organization Name:LABORATORIO NUCLEAR METROPOLITANO INC
Other - Org Name:SONUMET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:SOSTRE
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-781-1477
Mailing Address - Street 1:CARR 21 BLOQUE T-3 #1
Mailing Address - Street 2:LAS LOMAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921-3312
Mailing Address - Country:US
Mailing Address - Phone:787-781-1477
Mailing Address - Fax:787-793-2881
Practice Address - Street 1:T3- #1 CARR 21
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3312
Practice Address - Country:US
Practice Address - Phone:787-781-1477
Practice Address - Fax:787-793-2881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR261QR0200X261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherEIN
PR0029150Medicare PIN