Laboratorio Clinico Galeria Santa Cruz,Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

487 Issued in PR

Legal business name

LABORATORIO CLINICO GALERIA SANTA CRUZ,INC.

Practice address

64 Calle Santa Cruz Ste 105
Edificio Galeria Medica
Bayamon, PR 00961-7001

Phone

(787) 785-7919

Fax

(787) 778-7919

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Vivian Miranda, M.T. 656

Title

Director

Phone

(787) 785-7919

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328745600000",
    "number": "1285747659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1759",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009601759",
            "telephone_number": "787-785-7919",
            "fax_number": "787-778-7919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CALLE SANTA CRUZ STE 105",
            "address_2": "EDIFICIO GALERIA MEDICA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617001",
            "telephone_number": "787-785-7919",
            "fax_number": "787-778-7919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO GALERIA SANTA CRUZ,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2012-02-09",
        "status": "A",
        "authorized_official_last_name": "MIRANDA",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-785-7919",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T. 656"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bayamon, PR
• Providers in Bayamon, 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 Feb 9, 2012; 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.