Individual provider Active NPI

Iluminade Pacheco, MEDICAL TECHNOLOGYST

  • Medical Laboratory Technician
  • Sabana Grande, PR
National Provider Identifier
1114901899
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Laboratory TechnicianTaxonomy code 246RM2200X
License
2829 Issued in PR
Practice address
9 Angel Gregorio Martniez
Sabana Grande, PR 00637
Phone
(787) 804-1844
Fax
(787) 804-1844
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Laboratory Technician 246RM2200X 2829 PR Primary

Addresses

Primary practice location

9 Angel Gregorio Martniez
Sabana Grande, PR 00637

Mailing address

9 Angel Gregorio Martniez
Sabana Grande, PR 00637
Phone (787) 804-1844

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

LicenseStateTypeSpecialty
2829PRMDMedical Laboratory Technician

NPI Registry JSON

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114901899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 ANGEL GREGORIO MARTNIEZ",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "00637",
            "telephone_number": "787-804-1844",
            "fax_number": "787-804-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 ANGEL GREGORIO MARTNIEZ",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "00637",
            "telephone_number": "787-804-1844",
            "fax_number": "787-804-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "ILUMINADE",
        "name_prefix": "Mrs.",
        "credential": "MEDICAL TECHNOLOGYST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "PR",
            "license": "2829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.