Provider Demographics
NPI:1902826803
Name:GRUPO EMPRESAS DESALUD
Entity type:Organization
Organization Name:GRUPO EMPRESAS DESALUD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALOBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-767-8758
Mailing Address - Street 1:MARGILA130
Mailing Address - Street 2:EXPRESO TRUJILLOALTO
Mailing Address - City:TRUJILLOALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-751-9090
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL 130
Practice Address - Street 2:EXPRESO TRUJILLO ALTO
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-751-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0031499Medicare ID - Type UnspecifiedLAB