# MEDICAL PHARMACY AND LAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578772356
- **Authorized official:** MR. MIGUEL A ROBLEDO MD (PRESIDENTE)
- **Authorized official phone:** (787) 707-1983

## Contact information

- **Practice address:** AVENIDA ANDGLUCIA 771 PUERTO NUEVO, SAN JUAN, PR 00921-1803
- **Practice address phone:** (787) 707-1943
- **Practice address fax:** (787) 706-8823
- **Mailing address:** 771 AVE ANDALUCIA, PUERTO NUEVO, PR 00921-1803
- **Mailing address phone:** (787) 707-1983
- **Mailing address fax:** (787) 706-8823

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | PR | Yes |

## Other

- **Enumeration date:** 05/21/2007
- **Last updated:** 07/21/2022