Organization
LABORATORIO CLINICO PLAZA REAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAFAEL E SANTIAGO (ADMINISTRATOR)
(787) 720-1444
Entity
Organization
Contact information
Practice address
1 AVE ARBOLOTE, SUITE 302 PLAZA REAL MALL, GUAYNABO, PR 00969-2806
(787) 720-1444
(787) 963-0446
Mailing address
1 AVE ARBOLOTE, SUITE 302 PLAZA REAL MALL, GUAYNABO, PR 00969-2806
(787) 720-1444
(787) 963-0446
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
702
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051307
CRUZ AZUL DE PR
PR
01
—
1271
INTERNATIONAL MEDICAL CAR
PR
01
—
20213
AMERICAN HEALTH
PR
01
—
20278
PREFERRED MEDICAL CHOICE
PR
01
—
30716
SSS
PR
01
—
6570083
HUMANA
PR
01
—
800220
MMM PROVIDER NUMBER
PR
01
—
L-400141
PREFERRED HEALTH PLAN
PR
Enumeration date
10/26/2005
Last updated
11/01/2011
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