Organization Active NPI

Myrna E Montalvo Castillo

  • Clinical Medical Laboratory
  • Mayaguez, PR
National Provider Identifier
1023095791
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
794 Issued in PR
Legal business name
MYRNA E MONTALVO CASTILLO
Practice address
Urb. Mayaguez Terrace 1006 Calle Jose E. Arraras
Mayaguez, PR 00682-6635
Phone
(787) 265-1375
Fax
(787) 254-9645
NPI assigned
Dec 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Mrs. Myrna E Montalvo, M.T.NPI 1326025073
Title
Owner
Phone
(787) 265-1375

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 794 PR Primary

Addresses

Primary practice location

Urb. Mayaguez Terrace 1006 Calle Jose E. Arraras
Mayaguez, PR 00682-6635

Mailing address

Urb. Mayaguez Terrace 1006 Calle Jose E. Arraras
Mayaguez, PR 00682
Phone (787) 265-1375

Other names 1

  • LABORATORIO CLINICO DE HOSTOS Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100914001073 PR Part B Supplier - Independent Clinical Laboratory 2062451974 Practice locations: Mayaguez, PR

National Provider Directory

National Provider Directory

Locations

1006 Calle Jose E Arraras
Mayaguez, PR 00682
Phone (787) 265-1375

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1023095791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. MAYAGUEZ TERRACE 1006 CALLE JOSE E. ARRARAS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00682",
            "telephone_number": "787-265-1375",
            "fax_number": "787-254-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. MAYAGUEZ TERRACE 1006 CALLE JOSE E. ARRARAS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006826635",
            "telephone_number": "787-265-1375",
            "fax_number": "787-254-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYRNA E MONTALVO CASTILLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "MONTALVO",
        "authorized_official_first_name": "MYRNA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-265-1375",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO DE HOSTOS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LABORATORIO CLINICO DE HOSTOS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.