Active NPI
Myrna Santiago Camacho
- Clinical Medical Laboratory
- Bayamon, PR
National Provider Identifier
1043484231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 659
- Practice address
- 121 Ave Betances Urb Hermanas Davila
Bayamon, PR 00959 - Phone
- (787) 780-8000
- Fax
- (787) 740-7149
- NPI assigned
- Apr 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 659 | PR | Primary |
Addresses
Primary practice location
121 Ave Betances Urb Hermanas Davila
Bayamon, PR 00959
Mailing address
PO Box 51527
Toa Baja, PR 00950-1527
Phone (787) 780-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30513 | Other | PR | TRIPLE-S |
Other names 1
- Laboratorio Clinico Hermanas Davila
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 659 | PR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1043484231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 51527",
"city": "TOA BAJA",
"state": "PR",
"postal_code": "009501527",
"telephone_number": "787-780-8000",
"fax_number": "787-740-7149"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 AVE BETANCES URB HERMANAS DAVILA",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00959",
"telephone_number": "787-780-8000",
"fax_number": "787-740-7149"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO CAMACHO",
"first_name": "MYRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-17",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "659",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRIPLE-S",
"identifier": "30513",
"state": "PR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LABORATORIO CLINICO",
"last_name": "DAVILA",
"middle_name": "HERMANAS",
"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 Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.