Provider Demographics
NPI:1538229265
Name:LABORATORIO CLINICO SILMEND I
Entity type:Organization
Organization Name:LABORATORIO CLINICO SILMEND I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NORMA I.
Authorized Official - Middle Name:SILVAGNOLI
Authorized Official - Last Name:COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:BSMT
Authorized Official - Phone:787-847-0150
Mailing Address - Street 1:CALLE BARCELO 59
Mailing Address - Street 2:
Mailing Address - City:VILLALBA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00766
Mailing Address - Country:UM
Mailing Address - Phone:787-847-0150
Mailing Address - Fax:787-847-0150
Practice Address - Street 1:CALLE BARCELO 59
Practice Address - Street 2:
Practice Address - City:VILLALBA
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00766
Practice Address - Country:UM
Practice Address - Phone:787-847-0150
Practice Address - Fax:787-847-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR387291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0038355Medicare ID - Type Unspecified