Laboratorio Clinico Y de Referencia Puerto del Rey, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORIO CLINICO Y DE REFERENCIA PUERTO DEL REY, LLC

Practice address

Urb Fajardo Gardens
696 Calle Cipres
Fajardo, PR 00738

Phone

(787) 534-7181

NPI assigned

May 10, 2019

Organization subpart

No

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

Authorized official

Name

Wanda Ivette Aviles

Title

President

Phone

(787) 534-7181

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1557446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557446400000",
    "number": "1124684543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1635",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "007731635",
            "telephone_number": "787-534-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB FAJARDO GARDENS",
            "address_2": "696 CALLE CIPRES",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-534-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO Y DE REFERENCIA PUERTO DEL REY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-10",
        "last_updated": "2019-05-10",
        "status": "A",
        "authorized_official_last_name": "AVILES",
        "authorized_official_first_name": "WANDA",
        "authorized_official_middle_name": "IVETTE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-534-7181"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laboratorio Clinico Fajardo, Inc.
• Laboratorio Clinico Monte Sol, LLC
• Laboratorio Clinico Paoli, Inc
• Laboratorio Clinico Y de Ref de Fajardo Inc
• Laboratorio Clinico Y de Referencia de Fajardo, Inc.
• Yaritza Larregui, PHARMD, RPH
• Sugei Laureano, M.T.
• Adria Lebron Ayala, MD
• Ledesma Medical Ambulance LLC
• Ledesma Medical Transport

• Clinical Medical Laboratory in Fajardo, PR
• Providers in Fajardo, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2019; 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.