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Organization

MARIA L CRESPO

Active
Other names
Laboratorio Clinico Bacteriologico San Antonio
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARIA L CRESPO MTASCP (LABORATORY DIRECTOR)
(787) 890-6161
Entity
Organization

Contact information

Practice address
1065 AVE GENERAL RAMEY, SUITE 1, SAN ANTONIO, PR 00690-1117
(787) 890-6161
(787) 890-6161
Mailing address
PO BOX 791, SAN ANTONIO, PR 00690-0791
(787) 890-6161
(787) 890-6161

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
761
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0152
INTERNATIONAL MEDCAL CARD
PR
01
051502
BLUE CROSS
PR
01
20161
PREFERRED MEDICARE CHOCE
PR
01
30731
SSS
PR
01
40D0711458
CLIA
PR
01
5599
AMERICAN HEALTH MEDICARE
PR
01
6030045
HUMANA HEALTH/ INS
PR
01
800386
MMM
PR
01
A0170
FIRST PLUS
PR
01
LA0179
PAN AMERICAN LIFE
PR
Enumeration date
07/08/2006
Last updated
07/01/2008
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