Laboratorio Clinico Montehiedra Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

914 Issued in PR

Legal business name

LABORATORIO CLINICO MONTEHIEDRA INC.

Practice address

9410 Ave Los Romeros
Ste. 206
San Juan, PR 00926-7007

Phone

(787) 790-2377

Fax

(787) 272-2377

NPI assigned

Nov 27, 2006

Organization subpart

No

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

Authorized official

Name

Laura Cruz

Title

Vice President

Phone

(787) 790-2377

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": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629144399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9410 AVE LOS ROMEROS",
            "address_2": "STE. 206",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009267007",
            "telephone_number": "787-790-2377",
            "fax_number": "787-272-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9410 AVE LOS ROMEROS",
            "address_2": "STE. 206",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009267007",
            "telephone_number": "787-790-2377",
            "fax_number": "787-272-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO MONTEHIEDRA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "787-790-2377"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laboratorio Clinico Puerto Rico Holding, LLC
• Laboratorio Clinico Puerto Rico Holding, LLC

• Clinical Medical Laboratory in San Juan, PR
• Providers in San Juan, 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 Aug 22, 2020; 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.