NPIMap

Organization Active NPI

Laboratorio Clinico Plaza Palacios

  • Clinical Medical Laboratory
  • Toa Alta, PR
National Provider Identifier
1093102485
Registry record updated Apr 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO PLAZA PALACIOS
Practice address
Ave Los Palacios Interseccion Carr 167
Centro Comercial Plaza Palacios Local E-2
Toa Alta, PR 00953
Phone
(787) 605-8827
Fax
(787) 869-9988
NPI assigned
Apr 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2015

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

Authorized official

Name
Nixzaliz Marrero
Title
President
Phone
(787) 605-8827

Specialties & licenses 1

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

Addresses

Primary practice location

Ave Los Palacios Interseccion Carr 167
Centro Comercial Plaza Palacios Local E-2
Toa Alta, PR 00953

Mailing address

615 Carr 152 Suite 4
Naranjito, PR 00719
Phone (787) 605-8827

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151023002004 PR Part B Supplier - Independent Clinical Laboratory 9537478045 Practice locations: Toa Alta, PR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429747200000",
    "number": "1093102485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 CARR 152 SUITE 4",
            "city": "NARANJITO",
            "state": "PR",
            "postal_code": "00719",
            "telephone_number": "787-605-8827",
            "fax_number": "787-869-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE LOS PALACIOS INTERSECCION CARR 167",
            "address_2": "CENTRO COMERCIAL PLAZA PALACIOS LOCAL E-2",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-605-8827",
            "fax_number": "787-869-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PLAZA PALACIOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2015-04-23",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "NIXZALIZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-605-8827"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.