Laboratorio Clinico Plaza Real Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

702 Issued in PR

Legal business name

LABORATORIO CLINICO PLAZA REAL INC

Practice address

1 Ave Arbolote
Suite 302 Plaza Real Mall
Guaynabo, PR 00969-2806

Phone

(787) 720-1444

Fax

(787) 963-0446

NPI assigned

Oct 26, 2005

Last updated

Nov 1, 2011By 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

Mr. Rafael E Santiago

Title

Administrator

Phone

(787) 720-1444

Specialties & licenses 1

Addresses

Other identifiers 8

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.

• Raniel M. Verdejo, PH.D.

  • Clinical Psychologist
  • Ponce, PR
  • NPI 1508163940
  NPD (past)

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1639169006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AVE ARBOLOTE",
            "address_2": "SUITE 302 PLAZA REAL MALL",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009692806",
            "telephone_number": "787-720-1444",
            "fax_number": "787-963-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AVE ARBOLOTE",
            "address_2": "SUITE 302 PLAZA REAL MALL",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009692806",
            "telephone_number": "787-720-1444",
            "fax_number": "787-963-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PLAZA REAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-720-1444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "6570083",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH PLAN",
            "identifier": "L-400141",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MMM PROVIDER NUMBER",
            "identifier": "800220",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRUZ AZUL DE PR",
            "identifier": "051307",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH",
            "identifier": "20213",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SSS",
            "identifier": "30716",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "1271",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICAL CHOICE",
            "identifier": "20278",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laboratorio Clinico Lagos de Plata 2
• Laboratorio Clinico Las Colinas Inc.
• Laboratorio Clinico Munoz Rivera Inc (Laboratorio Clinico Munoz Rivera)
• Laboratorio Clinico Plaza Caparra
• Laboratorio Clinico Plaza Inc
• Laboratorio Clinico Principal San Fernando, Inc (Laboratorio Clinico Principal Caparra)
• Laboratorio Clinico Tintillo
• Isander Laboy Diaz, 1838P
• Miguel Laboy Rivera, 0867P
• Javier Laboy-Mercado, PSY.D

• Clinical Medical Laboratory in Guaynabo, PR
• Providers in Guaynabo, 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 Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.