NPIMap

Individual provider Active NPI

Ruth Davila, MT

  • Clinical Medical Laboratory
  • Bayamon, PR
National Provider Identifier
1013199900
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1266 Issued in PR
Practice address
1875 Carr 2 Ste 103
Medical Ohthalmic Plaza
Bayamon, PR 00959-7218
Phone
(787) 798-3176
Fax
(787) 288-0774
NPI assigned
Dec 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1266 PR Primary

Addresses

Primary practice location

1875 Carr 2 Ste 103
Medical Ohthalmic Plaza
Bayamon, PR 00959-7218

Mailing address

A31 Calle 1
Ext Villa Rica
Bayamon, PR 00959-5019
Phone (787) 798-3176

Other identifiers 1

IdentifierTypeStateIssuer
0038238OtherPRPTAN

Other names 1

  • Laboratorio Clinico Caribe Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
1266PRMDPediatric Occupational Therapist
580PRMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratorio Clinico Lugo Inc. Clinical Medical Laboratory Current Accepting new patients
Caribe Lab LLC Clinical Medical Laboratory Current Accepting new patients
Laboratorio Clinico Caribe Clinical Medical Laboratory Past Accepting new patients
Laboratorio Clinico San Fernando Clinical Medical Laboratory Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1013199900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A31 CALLE 1",
            "address_2": "EXT VILLA RICA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009595019",
            "telephone_number": "787-798-3176",
            "fax_number": "787-288-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 CARR 2 STE 103",
            "address_2": "MEDICAL OHTHALMIC PLAZA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009597218",
            "telephone_number": "787-798-3176",
            "fax_number": "787-288-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVILA",
        "first_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0038238",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LABORATORIO",
            "last_name": "CARIBE",
            "middle_name": "CLINICO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Bayamon, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.