Organization Active NPI

Bruno Rodriguez, Inc

  • Clinical Medical Laboratory
  • Manati, PR
National Provider Identifier
1124013123
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
239 Issued in PR
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, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
O20040528001103 PR Part B Supplier - Independent Clinical Laboratory 9133100688 Practice locations: Manati, PR

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.