Individual provider Active NPI

Carmen E Bague Cardona, MT

  • Medical Technologist
  • Carolina, PR
National Provider Identifier
1679603583
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
License
3151 Issued in PR
Practice address
33 - 17 Ave Roberto Clemente
Villa Carolina
Carolina, PR 00985
Phone
(787) 769-8349
Fax
(787) 252-8490
NPI assigned
Mar 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X 3151 PR Primary

Addresses

Primary practice location

33 - 17 Ave Roberto Clemente
Villa Carolina
Carolina, PR 00985

Mailing address

A5 Calle E
Eldorado
San Juan, PR 00926-3488
Phone (787) 274-1318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
3151PRMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679603583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "A5 CALLE E",
            "address_2": "ELDORADO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009263488",
            "telephone_number": "787-274-1318",
            "fax_number": "787-274-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 - 17 AVE ROBERTO CLEMENTE",
            "address_2": "VILLA CAROLINA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00985",
            "telephone_number": "787-769-8349",
            "fax_number": "787-252-8490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAGUE CARDONA",
        "first_name": "CARMEN",
        "middle_name": "E",
        "credential": "MT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "PR",
            "license": "3151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.