Provider Demographics
NPI:1720262728
Name:ZENAIDA GONZALEZ CABAN
Entity Type:Organization
Organization Name:ZENAIDA GONZALEZ CABAN
Other - Org Name:LABORATORIO CLINICO CUBA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ZENAIDA
Authorized Official - Middle Name:GONZALEZ
Authorized Official - Last Name:CABAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCDA
Authorized Official - Phone:787-818-2822
Mailing Address - Street 1:CALLE BARBOSA 326A
Mailing Address - Street 2:SECTOR CUBA
Mailing Address - City:MOCA
Mailing Address - State:PR
Mailing Address - Zip Code:00676
Mailing Address - Country:US
Mailing Address - Phone:787-818-2822
Mailing Address - Fax:787-818-2822
Practice Address - Street 1:CALLE BARBOSA 326A
Practice Address - Street 2:SECTOR CUBA
Practice Address - City:MOCA
Practice Address - State:PR
Practice Address - Zip Code:00676
Practice Address - Country:US
Practice Address - Phone:787-818-2822
Practice Address - Fax:787-818-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1137291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory