Active NPI
Bruno Rodriguez, Inc
- Clinical Medical Laboratory
- Manati, PR
National Provider Identifier
1124013123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 239
- Legal business name
- BRUNO RODRIGUEZ, INC
- Practice address
- Ave Colon #4
Suite #3
Manati, PR 00674-3050 - Phone
- (787) 854-2277
- Fax
- (787) 884-4281
- NPI assigned
- Sep 15, 2005
- Last updated
- Apr 7, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Zulma Rodriguez Pantoje Sr., MT
- Title
- Medical Technologist
- Phone
- (787) 854-2277
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 239 | PR | Primary |
Addresses
Primary practice location
Ave Colon #4
Suite #3
Manati, PR 00674-3050
Mailing address
PMB 160
PO Box 30500
Manati, PR 00674-3050
Phone (787) 854-2277
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040528001103 | PR | Part B Supplier - Independent Clinical Laboratory | 9133100688 | Practice locations: Manati, PR |
National Provider Directory
National Provider DirectoryLocations
4 Ave Colon
Manati, PR 00674
Phone (787) 854-2277
4 Ave Colon
Ste 3
Manati, PR 00674
Phone (787) 854-2277
A7 Calle Marginal
Manati, PR 00674
Phone (787) 854-2277
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Medical Technologist
- Ciales, PR
- NPI 1770928996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126742400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1239062400000",
"number": "1124013123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 160",
"address_2": "PO BOX 30500",
"city": "MANATI",
"state": "PR",
"postal_code": "006743050",
"telephone_number": "787-854-2277",
"fax_number": "787-884-4281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "AVE COLON #4",
"address_2": "SUITE #3",
"city": "MANATI",
"state": "PR",
"postal_code": "006743050",
"telephone_number": "787-854-2277",
"fax_number": "787-884-4281"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BRUNO RODRIGUEZ, INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-15",
"last_updated": "2009-04-07",
"status": "A",
"authorized_official_last_name": "RODRIGUEZ PANTOJE",
"authorized_official_first_name": "ZULMA",
"authorized_official_title_or_position": "MEDICAL TECHNOLOGIST",
"authorized_official_telephone_number": "787-854-2277",
"authorized_official_name_suffix": "Sr.",
"authorized_official_credential": "MT"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Manati, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.