NPIMap

Organization Active NPI

Laboratorio Clinico Jariselle P.S.C

  • Clinical Medical Laboratory
  • Toa Alta, PR
National Provider Identifier
1154754752
Registry record updated Nov 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1172 Issued in PR
Legal business name
LABORATORIO CLINICO JARISELLE P.S.C
Practice address
Carretera 829 KM 1.8
Bo Pinas
Toa Alta, PR 00953
Phone
(787) 730-7777
Fax
(787) 730-7777
NPI assigned
Aug 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2013

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

Authorized official

Name
Mrs. Bridget Jarinelle Vazquez, MT
Title
Medical Technologist
Phone
(787) 632-9550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1172 PR Primary

Addresses

Primary practice location

Carretera 829 KM 1.8
Bo Pinas
Toa Alta, PR 00953

Mailing address

RR3 Box 10728
Bo Pinas
Toa Alta, PR 00953
Phone (787) 730-7777

Other names 1

  • Laboratorio Clinico Jariselle Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081223000621 PR Part B Supplier - Independent Clinical Laboratory 1759443898 2 other NPIs on this enrollment
Practice locations: Bayamon, PR; Toa Alta, PR

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Laboratorio Clinico Jariselle PSC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10728 RR 3
Toa Alta, PR 00953

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384819200000",
    "number": "1154754752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR3 BOX 10728",
            "address_2": "BO PINAS",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-730-7777",
            "fax_number": "787-730-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA 829 KM 1.8",
            "address_2": "BO PINAS",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-730-7777",
            "fax_number": "787-730-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO JARISELLE P.S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-11-19",
        "status": "A",
        "authorized_official_last_name": "VAZQUEZ",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_middle_name": "JARINELLE",
        "authorized_official_title_or_position": "MEDICAL TECHNOLOGIST",
        "authorized_official_telephone_number": "787-632-9550",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Jariselle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 19, 2013; 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.