Active NPI
Maria De Lourdes Ventura
- Clinical Medical Laboratory
- San Juan, PR
National Provider Identifier
1497972962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 117
- Practice address
- 601 Calle Lodi
San Juan, PR 00924-3844 - Phone
- (787) 763-8435
- Fax
- (787) 764-6492
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 117 | PR | Primary |
Addresses
Primary practice location
601 Calle Lodi
San Juan, PR 00924-3844
Mailing address
PMB 48 PO Box 2500
Trujillo Alto, PR 00977-2500
Phone (787) 763-8435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30735 | Other | PR | SSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117 | PR | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497972962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PMB 48 PO BOX 2500",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "009772500",
"telephone_number": "787-763-8435",
"fax_number": "787-764-6492"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 CALLE LODI",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009243844",
"telephone_number": "787-763-8435",
"fax_number": "787-764-6492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENTURA",
"first_name": "MARIA",
"middle_name": "DE LOURDES",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "117",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SSS",
"identifier": "30735",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.