Laboratorio Clinico Santiago Irizarry Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

780 Issued in PR

Legal business name

LABORATORIO CLINICO SANTIAGO IRIZARRY INC

Practice address

Rudolfo Gonzalez #38
Rudolfo Gonzalez #38Int.
Adjuntas, PR 00601-2333

Phone

(787) 829-2541

Fax

(787) 829-2541

NPI assigned

Nov 26, 2007

Last updated

Sep 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ferdinand Santiago, MT(ASCP),MS

Title

President/Director

Phone

(787) 829-2541

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1196035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1417138991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RUDOLFO GONZALEZ # 38",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "006012333",
            "telephone_number": "787-829-2541",
            "fax_number": "787-829-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RUDOLFO GONZALEZ #38",
            "address_2": "RUDOLFO GONZALEZ #38INT.",
            "city": "ADJUNTAS",
            "state": "PR",
            "postal_code": "006012333",
            "telephone_number": "787-829-2541",
            "fax_number": "787-829-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO SANTIAGO IRIZARRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-26",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_title_or_position": "PRESIDENT/DIRECTOR",
        "authorized_official_telephone_number": "787-829-2541",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MT(ASCP),MS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrated Total Health Care Alliance
• International Medical & Hospital Supplies
• Edwin Irizarry, SLP, AU.D.
• Mariangely Irizarry
• Laboratorio Clinico Aili
• Laboratorio Clinico Santiago-Irizarry
• Zaira S Lugo Lopez, PSYD
• Adalberto Lugo, MD
• Arnaldo J Medina, D.M.D.
• Irmarie Mendez Velez, MRC

• Clinical Medical Laboratory in Adjuntas, PR
• Providers in Adjuntas, PR by specialty
• Clinical Medical Laboratory in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; 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.