Organization Active NPI

Laboratorio Clinico Plaza Cayey, Inc.

  • Clinical Medical Laboratory
  • Cayey, PR
National Provider Identifier
1194950519
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1188 Issued in PR
Legal business name
LABORATORIO CLINICO PLAZA CAYEY, INC.
Practice address
Carr #1 KM. 55.2 Suite 207
Caribbean Cinemas Building Plaza Cayey
Cayey, PR 00737
Phone
(787) 738-3838
NPI assigned
May 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Authorized official

Name
Brendalee Melendez Torres, M.T.
Title
General Supervisor
Phone
(787) 672-0339

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1188 PR Primary

Addresses

Primary practice location

Carr #1 KM. 55.2 Suite 207
Caribbean Cinemas Building Plaza Cayey
Cayey, PR 00737

Mailing address

Z5-4 15 St.
Urb. Turabo Gardens
Caguas, PR 00727
Phone (787) 738-3838

Other identifiers 1

IdentifierTypeStateIssuer
40D1079185OtherPRCLIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090814000320 PR Part B Supplier - Independent Clinical Laboratory 5294889903 Practice locations: Cayey, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1194950519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "Z5-4 15 ST.",
            "address_2": "URB. TURABO GARDENS",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00727",
            "telephone_number": "787-738-3838",
            "fax_number": "787-738-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR #1 KM. 55.2 SUITE 207",
            "address_2": "CARIBBEAN CINEMAS BUILDING PLAZA CAYEY",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00737",
            "telephone_number": "787-738-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PLAZA CAYEY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "MELENDEZ TORRES",
        "authorized_official_first_name": "BRENDALEE",
        "authorized_official_title_or_position": "GENERAL SUPERVISOR",
        "authorized_official_telephone_number": "787-672-0339",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "40D1079185",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cayey, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.