Brain Biology Lab. P.S.C.
Organization Active NPI Clinical Medical Laboratory · Carolina, PR
NPI 1356417232 · NPPES record last updated Feb 11, 2014
Key facts
- NPI
- 1356417232
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 1113 (PR)
- Legal business name
- BRAIN BIOLOGY LAB. P.S.C.
- Practice address
- 187 Calle Dalia
Suite 219 Isla Verde Mall
Carolina, PR 00979 - Phone
- (787) 791-9630
- Fax
- (787) 791-8481
- NPI assigned
- Nov 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Belinda Monge Cortes
- Title
- President
- Phone
- (787) 791-9630
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070222000309 | PR | Part B Supplier - Independent Clinical Laboratory | 6406958438 | Practice locations: Carolina, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 1113 | PR | Yes |
Addresses
Primary practice location
187 Calle Dalia
Suite 219 Isla Verde Mall
Carolina, PR 00979
Mailing address
PO Box 79875
Carolina, PR 00984-9875
Phone (787) 791-9630
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All providers in Carolina, PR · Clinical Medical Laboratory in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.