Laboratorio Clinico El Shaddai,Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

1148 Issued in PR

Legal business name

LABORATORIO CLINICO EL SHADDAI,INC.

Practice address

Carr 183 # KM7.7
Bo. Hato
San Lorenzo, PR 00754-4530

Phone

(787) 249-5350

Fax

(787) 736-8838

NPI assigned

Apr 21, 2008

Last updated

Apr 21, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carmen S. Ortiz, M.T.NPI 1174798052

Title

Medical Technologist

Phone

(787) 249-5350

Specialties & licenses 1

Addresses

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.

• Carmen S Ortiz, LCDA

  • Clinical Medical Laboratory
  • San Lorenzo, PR
  • NPI 1174798052
  NPD (past) Authorized official

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

{
    "created_epoch": "1208736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1164696134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5005",
            "address_2": "PMB 23",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007545005",
            "telephone_number": "787-249-5350",
            "fax_number": "787-736-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 183 # KM7.7",
            "address_2": "BO. HATO",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "007544530",
            "telephone_number": "787-249-5350",
            "fax_number": "787-736-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO EL SHADDAI,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-21",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEDICAL TECHNOLOGIST",
        "authorized_official_telephone_number": "787-249-5350",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Las Antillas PSC
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• Krysia Maria Lago, FNP-C
• Lantigua Medical Center LLC

• Clinical Medical Laboratory in San Lorenzo, PR
• Providers in San Lorenzo, 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 Apr 21, 2008; 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.