Organization
MARITZA E GRAJALES SOTO
Active
Other names
LAB CLINICO LA MILAGROSA
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARITZA E GRAJALES SOTO BSMTASCP (OWNER)
(787) 667-1902
Entity
Organization
Contact information
Practice address
AVE ROBERTO CLEMENTE CALLE 11 BLOQUE 33 # 17, URB VILLA CAROLINA, CAROLINA, PR 00985-5436
(787) 769-8349
(787) 257-8490
Mailing address
PO BOX 3386, CAROLINA, PR 00984-3386
(787) 769-8349
(787) 257-8490
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
266
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011266
GLOBAL HEALTH
PR
01
—
1049
AMERICAN HEALTH
PR
01
—
20425
PREFFERED MEDICARE CHOICE
PR
01
—
30387
MEDICARE OPTIMO
PR
01
—
30387CL
SSS & SSS OPTIMO
PR
01
—
400643
UTI- PREFFERED HEALTH
PR
01
—
40D0658056
CLIA
PR
01
—
50370
CRUZ AZUL
PR
01
—
6300078
HUMANA
PR
01
—
800210
MEDICARE Y MUCHO MAS-MMM
PR
01
—
8392
FIRST MEDICAL- I.M.C.
PR
01
—
ITIN
CIGNA & CIGNA EXCLUSIVE
PR
01
—
LA0066
PALIC- PANAMERICAN LIFE
PR
Enumeration date
01/30/2006
Last updated
07/30/2014
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