Active NPI
Laboratorio Clinico Jezer, LLC
- Clinical Medical Laboratory
- Moca, PR
National Provider Identifier
1689352353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- LABORATORIO CLINICO JEZER, LLC
- Doing business as
- LABORATORIO CLINICO JEZER
- Practice address
- Carr 110 KM 10.6
Moca, PR 00676 - Phone
- (787) 877-2010
- Fax
- (787) 986-7653
- NPI assigned
- Jul 11, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Eileen Hernandez Lopez
- Title
- President
- Phone
- (787) 235-5255
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
Carr 110 KM 10.6
Moca, PR 00676
Mailing address
HC 5 Box 10433
Moca, PR 00676-9713
Phone (787) 877-2010
Other names 1
- LABORATORIO CLINICO JEZER
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231018001732 | PR | Part B Supplier - Independent Clinical Laboratory | 9032564562 | Practice locations: Moca, PR |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Medical Technologist
- Moca, PR
- NPI 1710295928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689033600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1690761600000",
"number": "1689352353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 5 BOX 10433",
"city": "MOCA",
"state": "PR",
"postal_code": "006769713",
"telephone_number": "787-877-2010",
"fax_number": "787-986-7653"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 110 KM 10.6",
"city": "MOCA",
"state": "PR",
"postal_code": "00676",
"telephone_number": "787-877-2010",
"fax_number": "787-986-7653"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORIO CLINICO JEZER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-07-11",
"last_updated": "2023-07-31",
"certification_date": "2023-07-31",
"status": "A",
"authorized_official_last_name": "HERNANDEZ LOPEZ",
"authorized_official_first_name": "EILEEN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "787-235-5255",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LABORATORIO CLINICO JEZER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Moca, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; 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.