Provider Demographics
NPI:1952584997
Name:VICENTE, SARA E (BS MT ASCP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:VICENTE
Suffix:
Gender:F
Credentials:BS MT ASCP
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:URB ESTANCIAS DE YAUCO H2 CALLE TURQUESA
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698
Mailing Address - Country:US
Mailing Address - Phone:787-267-4407
Mailing Address - Fax:787-267-1202
Practice Address - Street 1:CARR #127 KM 03 BO SUSUA BAJA
Practice Address - Street 2:SECTOR 4 CALLES SOLAR #1
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-267-4407
Practice Address - Fax:787-267-1202
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory