Laboratorio Clinico Vega Alta

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

458 Issued in PR

Legal business name

LABORATORIO CLINICO VEGA ALTA

Practice address

54 Calle Colon
Vega Alta, PR 00692-7074

Phone

(787) 883-3765

Fax

(787) 270-2337

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Omar A Cancel

Title

Administrator

Phone

(787) 883-3765

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400112000000",
    "number": "1598802845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 CALLE COLON",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006927074",
            "telephone_number": "787-883-3765",
            "fax_number": "787-270-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 CALLE COLON",
            "city": "VEGA ALTA",
            "state": "PR",
            "postal_code": "006927074",
            "telephone_number": "787-883-3765",
            "fax_number": "787-270-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO VEGA ALTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-05-15",
        "status": "A",
        "authorized_official_last_name": "CANCEL",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-883-3765",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Teresita
• Angel L Landron-Landron, BS, LND, DE
• Ismael Angel Landron, M.D.
• Alma Latoni Benedetti, OD
• Angel Luis Laureano-Vega, LICENCED OPTICIAN

• Clinical Medical Laboratory in Vega Alta, PR
• Providers in Vega Alta, 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 May 15, 2014; 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.