Individual provider Active NPI

Wilfredo Reyes, M.T.

  • Laboratory Management Specialist/Technologist
  • Carolina, PR
National Provider Identifier
1710021365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Laboratory Management Specialist/TechnologistTaxonomy code 246QL0900X
License
1202 Issued in PR
Practice address
PC1 Calle 274
Ave Comandante, Country Club
Carolina, PR 00982-2769
Phone
(787) 762-4200
Fax
(787) 762-4200
NPI assigned
Feb 16, 2007
Sex
Male
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
Laboratory Management Specialist/Technologist 246QL0900X 1202 PR Primary

Addresses

Primary practice location

PC1 Calle 274
Ave Comandante, Country Club
Carolina, PR 00982-2769

Mailing address

1206 Ave Magdalena
San Juan, PR 00907-1728
Phone (787) 667-1033

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
1202PRMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Laboratorio Clinico Doctor Center, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710021365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 AVE MAGDALENA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009071728",
            "telephone_number": "787-667-1033",
            "fax_number": "787-762-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PC1 CALLE 274",
            "address_2": "AVE COMANDANTE, COUNTRY CLUB",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009822769",
            "telephone_number": "787-762-4200",
            "fax_number": "787-762-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "WILFREDO",
        "credential": "M.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QL0900X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Laboratory Management",
            "state": "PR",
            "license": "1202",
            "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.