Organization
UNIVERSITY PATHOLOGISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL A MARCIAL MD (PRESIDENT)
(787) 726-5484
Entity
Organization
Contact information
Practice address
COND MADRID 1760 LOIZA STREET, SUITE 204, SAN JUAN, PR 00911-1801
(787) 726-5486
(787) 268-4417
Mailing address
COND MADRID 1760 LOIZA STREET, SUITE #204, SAN JUAN, PR 00911-1801
(787) 726-5486
(787) 268-4417
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
121
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
067852
CRUZ AZUL PROVIDER #
PR
01
—
800078
MMM PROVIDER NUMBER
PR
01
—
81063
TRIPLE-S, INC. PROVIDER #
PR
01
—
9140009
HUMANA PROVIDER NUMBER
PR
Enumeration date
10/06/2005
Last updated
04/27/2010
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