Laboratorio Clinico Amundaray, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORIO CLINICO AMUNDARAY, INC

Practice address

8155 Calle Concordia
Ste 101
Ponce, PR 00717-1547

Phone

(787) 842-9760

Fax

(787) 844-0898

NPI assigned

Feb 15, 2006

Last updated

Jan 7, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Dagmar L. SantiagoNPI 1700816188

Title

Owner/Administrator

Phone

(787) 842-9760

Specialties & licenses 1

Addresses

Other names 1

• Laboratorio Clinico Amundaray, Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

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.

• Dagmar L. Santiago

  • Clinical Medical Laboratory
  • Ponce, PR
  • NPI 1700816188
  NPD Authorized official

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1639143886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2457 CALLE EUREKA",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007172219",
            "telephone_number": "787-842-9760",
            "fax_number": "787-844-0898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8155 CALLE CONCORDIA",
            "address_2": "STE 101",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171547",
            "telephone_number": "787-842-9760",
            "fax_number": "787-844-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO AMUNDARAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "DAGMAR",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "787-842-9760",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Amundaray, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Medical Laboratory in Ponce, PR
• Providers in Ponce, 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 Jan 7, 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.