Provider Demographics
NPI:1831349224
Name:MCI LAND CORPORATION
Entity type:Organization
Organization Name:MCI LAND CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT, ASCP
Authorized Official - Phone:787-415-3232
Mailing Address - Street 1:PO BOX 8418
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8418
Mailing Address - Country:US
Mailing Address - Phone:787-852-7722
Mailing Address - Fax:
Practice Address - Street 1:PR 924 KM 2.8
Practice Address - Street 2:BO. COLLORES
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCI LAND CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1165291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory