NPIMap

Organization Active NPI

Laboratorio Clinico Villa Los Santos

  • Clinical Medical Laboratory
  • Arecibo, PR
National Provider Identifier
1073583514
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
585 Issued in PR
Legal business name
LABORATORIO CLINICO VILLA LOS SANTOS
Practice address
V1 Calle 16
Urb. Villa Los Santos
Arecibo, PR 00612-3112
Phone
(787) 879-1609
Fax
(787) 880-3733
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Maria Gonzalez
Title
Directora
Phone
(787) 879-1609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 585 PR Primary

Addresses

Primary practice location

V1 Calle 16
Urb. Villa Los Santos
Arecibo, PR 00612-3112

Mailing address

PO Box 9091
Cotto Station
Arecibo, PR 00613-9091
Phone (787) 879-1609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060614000264 PR Part B Supplier - Independent Clinical Laboratory 2769494681 Practice locations: Arecibo, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073583514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9091",
            "address_2": "COTTO STATION",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006139091",
            "telephone_number": "787-879-1609",
            "fax_number": "787-880-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "V1 CALLE 16",
            "address_2": "URB. VILLA LOS SANTOS",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006123112",
            "telephone_number": "787-879-1609",
            "fax_number": "787-880-3733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO VILLA LOS SANTOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTORA",
        "authorized_official_telephone_number": "787-879-1609",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.