Organization
UNIVERSITY PATHOLOGY ASSOCIATES, PCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILFRED REYES (ADMINISTRATOR)
(787) 250-0251
Entity
Organization
Contact information
Practice address
HOSPITAL AUXILIO MUTUO 3ER PISO, EDIFICIO VIEJO, SAN JUAN, PR 00917
(787) 753-5336
(787) 753-5337
Mailing address
PO BOX 21380, SAN JUAN, PR 00928
(787) 250-0251
(787) 250-0219
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
90B
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100583
CRUZ AZUL PROVIDER NUMBER
PR
01
—
821486
MMM PROVIDER NUMBER
PR
01
—
84921
TRIPLE-S, INC. PROVIDER #
PR
01
—
9170513
HUMANA PROVIDER NUMBER
PR
Enumeration date
10/06/2005
Last updated
10/31/2012
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