Provider Demographics
NPI:1740491547
Name:E & E DIAGNOSTIC SERVICES, INC
Entity type:Organization
Organization Name:E & E DIAGNOSTIC SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-784-2025
Mailing Address - Street 1:PO BOX 51485
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1485
Mailing Address - Country:US
Mailing Address - Phone:787-784-2025
Mailing Address - Fax:787-261-1030
Practice Address - Street 1:STRET . LUZ P 12 4TA SECCION
Practice Address - Street 2:LEVITTOWN
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-1485
Practice Address - Country:US
Practice Address - Phone:787-784-2025
Practice Address - Fax:787-261-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR8-8919Medicare ID - Type UnspecifiedCARDIO VASCULAR DIAGNOSTI