Provider Demographics
NPI:1487873139
Name:LABORATORIO CLINICO RAMOS
Entity type:Organization
Organization Name:LABORATORIO CLINICO RAMOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND GENERAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ-MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MT ASCP
Authorized Official - Phone:787-832-0445
Mailing Address - Street 1:55 CALLE DR BASORA N
Mailing Address - Street 2:EDIFICIO MEDICO IV
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4810
Mailing Address - Country:US
Mailing Address - Phone:787-832-0445
Mailing Address - Fax:787-831-0090
Practice Address - Street 1:55 CALLE DR BASORA N
Practice Address - Street 2:EDIFICIO MEDICO IV
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4810
Practice Address - Country:US
Practice Address - Phone:787-832-0445
Practice Address - Fax:787-831-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0446291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR38268Medicare ID - Type UnspecifiedPROVIDER NUMBER