Individual
JAIME TAVAREZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
58 CALLE DAGUEY, ANASCO, PR 00610-2603
(787) 826-3072
(787) 826-3072
Mailing address
PO BOX 956, ISABELA, PR 00662-0956
(787) 872-3480
(787) 872-3480
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
690
PR
Other
Enumeration date
01/31/2008
Last updated
07/17/2013
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