Provider Demographics
NPI:1649238650
Name:LABORATORIO CLINICO ALEJANDRINO, INC.
Entity type:Organization
Organization Name:LABORATORIO CLINICO ALEJANDRINO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL CONSULTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNALDO
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-764-4593
Mailing Address - Street 1:310 AVE LOMAS VERDES
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6638
Mailing Address - Country:US
Mailing Address - Phone:787-764-4593
Mailing Address - Fax:787-276-0677
Practice Address - Street 1:310 LOMAS VERDES AVE.
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6638
Practice Address - Country:US
Practice Address - Phone:787-764-4593
Practice Address - Fax:787-276-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR882291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031450Medicare ID - Type UnspecifiedLABORATORIO ALEJANDRINO