Organization
LARES MEDICAL CENTER VACUNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODRIGUEZ BALTAZAR (DIRECTOR)
(787) 897-1444
Entity
Organization
Contact information
Practice address
CARR 111 KM 2.9 AVE LOS PATRIOTAS, LARES, PR 00669
(787) 897-1444
(787) 897-4952
Mailing address
PO BOX 1427, LARES, PR 00669-1427
(787) 897-1444
(787) 897-4952
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
2155
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17114
LARES MEDICAL CENTER VACU
PR
Enumeration date
05/11/2007
Last updated
08/22/2020
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