Individual provider Active NPI

Carlos J Febles Mena

  • Clinical Medical Laboratory
  • Orocovis, PR
National Provider Identifier
1386889210
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1048 Issued in PR
Practice address
Carretera #155 KM 31.5
Bo. Gato
Orocovis, PR 00720
Phone
(787) 867-3007
Fax
(787) 867-3007
NPI assigned
Dec 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1048 PR Primary
Clinical Medical Laboratory 291U00000X 993 PR

Addresses

Primary practice location

Carretera #155 KM 31.5
Bo. Gato
Orocovis, PR 00720

Mailing address

Estrella del Mar M-10
Dorado del Mar
Dorado, PR 00646
Phone (787) 647-2910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060605000194 PR Part B Supplier - Independent Clinical Laboratory 5597776625 Practice locations: Orocovis, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1048PRMDClinical Medical Laboratory
993PRMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423008000000",
    "number": "1386889210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ESTRELLA DEL MAR M-10",
            "address_2": "DORADO DEL MAR",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-647-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARRETERA #155 KM 31.5",
            "address_2": "BO. GATO",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "00720",
            "telephone_number": "787-867-3007",
            "fax_number": "787-867-3007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEBLES MENA",
        "first_name": "CARLOS",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-05",
        "last_updated": "2015-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1048",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orocovis, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.