Provider Demographics
NPI:1770349466
Name:LABORATORIO CLINICO OCEAN FRONT INC.
Entity type:Organization
Organization Name:LABORATORIO CLINICO OCEAN FRONT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NORDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-390-0642
Mailing Address - Street 1:PO BOX 1685
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1685
Mailing Address - Country:US
Mailing Address - Phone:787-346-8579
Mailing Address - Fax:
Practice Address - Street 1:12 CALLE PALMER
Practice Address - Street 2:
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-3217
Practice Address - Country:US
Practice Address - Phone:787-871-1205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory