Provider Demographics
NPI:1841256906
Name:LABORATORIO CLINICO NAZARET
Entity type:Organization
Organization Name:LABORATORIO CLINICO NAZARET
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-884-5252
Mailing Address - Street 1:PO BOX 4472
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4472
Mailing Address - Country:US
Mailing Address - Phone:787-884-5252
Mailing Address - Fax:787-884-5252
Practice Address - Street 1:CARR 2
Practice Address - Street 2:KM. 46.4 BO. COTTO NORTE
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-5765
Practice Address - Country:US
Practice Address - Phone:787-884-5252
Practice Address - Fax:787-884-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1103291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory