Organization
JOSE A. ROLDAN-CORREA
Active
Other names
laboratorio clinico rio canas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE A ROLDAN-CORREA M.T (OWNER)
(787) 747-1930
Entity
Organization
Contact information
Practice address
ST RD 798 KM 0.5 , RIO CANAS, CAGUAS, PR 00725-0001
(787) 747-1930
(787) 747-5931
Mailing address
280 LA SERRANIA, CAGUAS, PR 00725-1810
(787) 747-1930
(787) 747-5931
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
948
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031322
MEDICARE PART B PROVIDER
PR
Enumeration date
03/03/2007
Last updated
04/07/2010
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