Provider Demographics
NPI:1952359739
Name:BORINQUEN LABORATORY SERVICES
Entity Type:Organization
Organization Name:BORINQUEN LABORATORY SERVICES
Other - Org Name:LABORATORIO CLINICO PASEOS II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINA
Authorized Official - Middle Name:I
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:M T ASCP
Authorized Official - Phone:787-753-6082
Mailing Address - Street 1:PO BOX 14334
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00916-4334
Mailing Address - Country:US
Mailing Address - Phone:787-753-6082
Mailing Address - Fax:787-764-1909
Practice Address - Street 1:76 CALLE BOLIVIA
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-2121
Practice Address - Country:US
Practice Address - Phone:787-753-6082
Practice Address - Fax:787-764-1909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BORINQUEN LABORATORY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-04
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR588291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory