Laboratorio Clinico Esmeralda Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

386 Issued in PR

Legal business name

LABORATORIO CLINICO ESMERALDA INC

Practice address

207 Ave Esmeralda
Ponce de Leon
Guaynabo, PR 00969-4448

Phone

(787) 720-6943

Fax

(787) 790-7060

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Miss Nelly E Acevedo, M.T.

Title

Director

Phone

(787) 720-6943

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1457330144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 AVE ESMERALDA",
            "address_2": "PONCE DE LEON",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694448",
            "telephone_number": "787-720-6943",
            "fax_number": "787-790-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 AVE ESMERALDA",
            "address_2": "PONCE DE LEON",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009694448",
            "telephone_number": "787-720-6943",
            "fax_number": "787-790-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO ESMERALDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "NELLY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-720-6943",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS PROVIDER NUMBER",
            "identifier": "30332",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Guaynabo
• Laboratorio Clinico Jomyr III, LLC

• Clinical Medical Laboratory in Guaynabo, PR
• Providers in Guaynabo, 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 Dec 10, 2007; 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.