Organization Active NPI

Laboratorio Clinico El Senorial, Inc

  • Clinical Medical Laboratory
  • San Juan, PR
National Provider Identifier
1679540272
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
797 Issued in PR
Legal business name
LABORATORIO CLINICO EL SENORIAL, INC
Practice address
180 Ave Winston Churchill
Urb Crown Hills
San Juan, PR 00926-6013
Phone
(787) 751-7028
Fax
(787) 754-6568
NPI assigned
Mar 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Authorized official

Name
Ms. Maria Del Carmen Roman, MT
Title
Owner
Phone
(787) 751-7028

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 797 PR Primary

Addresses

Primary practice location

180 Ave Winston Churchill
Urb Crown Hills
San Juan, PR 00926-6013

Mailing address

180 Ave Winston Churchill
Urb Crown Hills
San Juan, PR 00926-6013
Phone (787) 751-7028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120319000773 PR Part B Supplier - Independent Clinical Laboratory 0345400966 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory

Locations

180 Ave Winston Churchill
San Juan, PR 00926
Phone (787) 647-2930

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1679540272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 AVE WINSTON CHURCHILL",
            "address_2": "URB CROWN HILLS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266013",
            "telephone_number": "787-751-7028",
            "fax_number": "787-754-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 AVE WINSTON CHURCHILL",
            "address_2": "URB CROWN HILLS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266013",
            "telephone_number": "787-751-7028",
            "fax_number": "787-754-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO EL SENORIAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "DEL CARMEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-751-7028",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; 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.