Provider Demographics
NPI:1912954470
Name:LABORATORIO CLINICO EL ROSARIO INC
Entity Type:Organization
Organization Name:LABORATORIO CLINICO EL ROSARIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MONTANEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-553-0387
Mailing Address - Street 1:PO BOX 3031
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-3031
Mailing Address - Country:US
Mailing Address - Phone:787-855-3434
Mailing Address - Fax:787-855-3434
Practice Address - Street 1:AVE TRIO VEGABAJENO U-16
Practice Address - Street 2:URB. EL ROSARIO
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-855-3434
Practice Address - Fax:787-855-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory