Laboratorio Clinico del Pueblo Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

682 Issued in PR

Legal business name

LABORATORIO CLINICO DEL PUEBLO INC

Practice address

96 Calle Carazo
Guaynabo, PR 00969

Phone

(787) 720-4140

Fax

(787) 720-0101

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Daniel Lipton

Title

President

Phone

(787) 720-4120

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

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

• Carlos A. Bujosa, M.D.

  • Adult Medicine Physician
  • Guaynabo, PR
  • NPI 1053387506
  NPD (past)
• Petra J Ortiz, M.D.

  • General Practice Physician
  • Guaynabo, PR
  • NPI 1609970094
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1235249954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-720-4140",
            "fax_number": "787-720-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00969",
            "telephone_number": "787-720-4140",
            "fax_number": "787-720-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO DEL PUEBLO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "LIPTON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-720-4120"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038222400",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "40D0658100",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Gordo
• Laboratorio Clinico Gordo Inc.
• Laboratorio Clinico Guaynabo

• Clinical Medical Laboratory in Guaynabo, PR
• Providers in Guaynabo, 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 Sep 20, 2023; 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.