Individual provider Active NPI

Carmen Cermira Rivera Marcano, BA NT ASCP

  • Clinical Medical Laboratory
  • San Lorenzo, PR
National Provider Identifier
1306831318
Registry record updated Nov 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1095 Issued in PR
Practice address
Munoz Rivera St 5 Sur
San Lorenzo, PR 00754
Phone
(787) 548-5816
NPI assigned
Sep 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X 1095 PR
Medical Laboratory Technician 246RM2200X 1095 PR
Clinical Medical Laboratory 291U00000X 1095 PR Primary

Addresses

Primary practice location

Munoz Rivera St 5 Sur
San Lorenzo, PR 00754

Mailing address

Munoz Rivera St 5 Sur
Laboratorio Licer
San Lorenzo, PR 00754
Phone (787) 736-2951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Arts

State licenses

LicenseStateTypeSpecialty
1095PRMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384387200000",
    "number": "1306831318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MUNOZ RIVERA ST 5 SUR",
            "address_2": "LABORATORIO LICER",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "00754",
            "telephone_number": "787-736-2951",
            "fax_number": "787-715-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MUNOZ RIVERA ST 5 SUR",
            "city": "SAN LORENZO",
            "state": "PR",
            "postal_code": "00754",
            "telephone_number": "787-548-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA MARCANO",
        "first_name": "CARMEN",
        "middle_name": "CERMIRA",
        "name_prefix": "Ms.",
        "credential": "BA NT ASCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-15",
        "last_updated": "2013-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "PR",
            "license": "1095",
            "primary": false
        },
        {
            "code": "246RM2200X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Medical Laboratory",
            "state": "PR",
            "license": "1095",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Lorenzo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2013; 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.