NPIMap

Organization Active NPI

La Vida Medical Group Hatillo Corp

  • Clinical Medical Laboratory
  • Hatillo, PR
National Provider Identifier
1326219650
Registry record updated May 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LA VIDA MEDICAL GROUP HATILLO CORP
Practice address
549 Calle del Mar
Suite 302
Hatillo, PR 00659-2869
Phone
(787) 880-2363
Fax
(787) 881-4312
NPI assigned
Mar 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2008

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

Authorized official

Name
Mrs. Diana I Matos
Title
Billing Manager
Phone
(787) 880-2363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

549 Calle del Mar
Suite 302
Hatillo, PR 00659-2869

Mailing address

549 Calle del Mar
Suite 302
Hatillo, PR 00659-2869
Phone (787) 880-2363

Other names 1

  • LABORATORIO CLINICO LOS ANGELES MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

549 Calle del Mar
Ste 302
Hatillo, PR 00659
Phone (787) 880-2363

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1326219650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 CALLE DEL MAR",
            "address_2": "SUITE 302",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592869",
            "telephone_number": "787-880-2363",
            "fax_number": "787-881-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 CALLE DEL MAR",
            "address_2": "SUITE 302",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592869",
            "telephone_number": "787-880-2363",
            "fax_number": "787-881-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA MEDICAL GROUP HATILLO CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "MATOS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "787-880-2363",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LABORATORIO CLINICO LOS ANGELES MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hatillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.