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Organization

LABORATORIO CLINICO FERNANDO MONTILLA, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ALMA R. SAN MIGUEL MT-ASCP (DIRECTOR)
(787) 765-4215
Entity
Organization

Contact information

Practice address
401 CALLE FERNANDO MONTILLA, SAN JUAN, PR 00918-2676
(787) 765-4215
Mailing address
PO BOX 362001, SAN JUAN, PR 00936-2001
(787) 765-4215
(787) 764-3178

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
395
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
395
STATE LICENSE
PR
Enumeration date
06/15/2005
Last updated
08/22/2020
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