Organization Active NPI

Laboratorio Clinico Paseo del Sur Inc

  • Clinical Medical Laboratory
  • Ponce, PR
National Provider Identifier
1346545175
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LABORATORIO CLINICO PASEO DEL SUR INC
Practice address
Centro Comercial Paseo del Sur Plaza, Suite C
Barrio Vallas Torres 291 Ave. Los Caobos
Ponce, PR 00731
Phone
(787) 505-9195
NPI assigned
Jan 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Mrs. Maria Esther Colon, M.T.
Title
Supervisor
Phone
(787) 505-9195

Specialties & licenses 1

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

Addresses

Primary practice location

Centro Comercial Paseo del Sur Plaza, Suite C
Barrio Vallas Torres 291 Ave. Los Caobos
Ponce, PR 00731

Mailing address

Qintas de Monserrate El Greco C1
Ponce, PR 00730-1706
Phone (787) 505-9195

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120316000165 PR Part B Supplier - Independent Clinical Laboratory 4082873682 Practice locations: Ponce, PR

National Provider Directory

National Provider Directory

Locations

291 Ave Los Caobos
Ste C
Ponce, PR 00715
Phone (787) 505-9195

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1346545175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "QINTAS DE MONSERRATE EL GRECO C1",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007301706",
            "telephone_number": "787-505-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO COMERCIAL PASEO DEL SUR PLAZA, SUITE C",
            "address_2": "BARRIO VALLAS TORRES 291 AVE. LOS CAOBOS",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-505-9195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PASEO DEL SUR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "COLON",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ESTHER",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "787-505-9195",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.