Provider Demographics
NPI:1053559203
Name:LABORATORIO CLINICO SANTA MARIA
Entity type:Organization
Organization Name:LABORATORIO CLINICO SANTA MARIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:787-844-4774
Mailing Address - Street 1:PO BOX 8173
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-8173
Mailing Address - Country:US
Mailing Address - Phone:787-844-4774
Mailing Address - Fax:787-813-5781
Practice Address - Street 1:CALLE FERROCARRIL 450
Practice Address - Street 2:SANTA MARIA MEDICAL BUILDING OFICINA 103
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-844-4774
Practice Address - Fax:787-813-5781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory