Provider Demographics
NPI:1649349663
Name:TEST CARE DIAGNOSTICS, INC.
Entity type:Organization
Organization Name:TEST CARE DIAGNOSTICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:OCTAVIO
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-792-1398
Mailing Address - Street 1:PMB 254, #90, AVE RIO HONDO
Mailing Address - Street 2:
Mailing Address - City:BAYANON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3105
Mailing Address - Country:US
Mailing Address - Phone:787-792-1398
Mailing Address - Fax:787-792-1398
Practice Address - Street 1:AVE. SAN PATRICIO, #777 URB. LAS LOMAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-792-1398
Practice Address - Fax:787-792-1398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3549OtherAMERICAN HEALTH MEDICARE
PR9210185OtherHUMANA
PR992124OtherMMM
PR992124OtherMMM