Organization
LABORATORIO PERIFEROVASCULAR CSA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIBETH CASTRO (ADMINISTRATOR)
(787) 879-4632
Entity
Organization
Contact information
Practice address
622 AVE SAN LUIS CARR. 129, ARECIBO, PR 00612-0575
(787) 879-4632
(787) 881-5762
Mailing address
PO BOX 575, ARECIBO, PR 00613-0575
(787) 879-4632
(787) 881-5762
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
207R10011X
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207R10011X
INTERNAL MEDICINE
PR
01
—
6407
INTERVENTIONAL CARDIOLOGY
PR
Enumeration date
10/10/2013
Last updated
03/07/2023
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