NPIMap

Organization Active NPI

Lares Medical Center Inc.

  • Clinical Medical Laboratory
  • Lares, PR
National Provider Identifier
1629006572
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
942 Issued in PR
Legal business name
LARES MEDICAL CENTER INC.
Practice address
Carr 111 KM 2.9 Ave Los Patriotas
Lares, PR 00669
Phone
(787) 897-1444
Fax
(787) 897-4952
NPI assigned
Jun 29, 2006
Last updated
Nov 6, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
LARES MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Dr. Rodriguez Baltazar
Title
Director
Phone
(787) 897-1444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 942 PR Primary

Addresses

Primary practice location

Carr 111 KM 2.9 Ave Los Patriotas
Lares, PR 00669

Mailing address

PO Box 1427
Lares, PR 00669-1427
Phone (787) 897-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090217000726 PR Part B Supplier - Independent Clinical Laboratory 8527054477 Practice locations: Camuy, PR; Lares, PR

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lares Medical Group Inc13 organizations share this tax ID, including this one
Part of
Lares Medical Group Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1629006572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1427",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006691427",
            "telephone_number": "787-897-1444",
            "fax_number": "787-897-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 111 KM 2.9 AVE LOS PATRIOTAS",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-897-1444",
            "fax_number": "787-897-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARES MEDICAL CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LARES MEDICAL CENTER INC",
        "enumeration_date": "2006-06-29",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "BALTAZAR",
        "authorized_official_first_name": "RODRIGUEZ",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-897-1444",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.