Organization
LABORATORIO CLINICO EBENEZER LLC
Active
Organization
LABORATORIO CLINICO EBENEZER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ENILDA VELAZQUEZ PB MT, MLS (ASCP) (OWNER)
(787) 233-1313
Entity
Organization
Contact information
Practice address
PR 8860 KM 1.2, PLAZA MATIENZO BO CUEVAS, TRUJILLO ALTO, PR 00976
(787) 233-1313
Mailing address
2C25 AVE C, CAROLINA, PR 00987-7481
(787) 220-1558
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255788386
—
PR
Enumeration date
03/20/2019
Last updated
03/20/2019
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