Laboratorio Clinico Bacteriologico Santiago Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

LABORATORIO CLINICO BACTERIOLOGICO SANTIAGO INC

Practice address

Calle Dr. Cueto
# 83
Utuado, PR 00641

Phone

(787) 894-7482

NPI assigned

Nov 10, 2009

Last updated

Jan 12, 2024By 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

Raimundo Rivera-Perez

Title

President

Phone

(787) 894-7482

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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.

• Karla Cristina Rodriguez, M.D.

  • General Practice Physician
  • Utuado, PR
  • NPI 1164688065
  NPD (past)

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1740517911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE DR. CUETO",
            "address_2": "# 83",
            "city": "UTUADO",
            "state": "PR",
            "postal_code": "00641",
            "telephone_number": "787-894-7482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE DR. CUETO",
            "address_2": "# 83",
            "city": "UTUADO",
            "state": "PR",
            "postal_code": "00641",
            "telephone_number": "787-894-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO BACTERIOLOGICO SANTIAGO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-10",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "RIVERA-PEREZ",
        "authorized_official_first_name": "RAIMUNDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-894-7482"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Utuado, PR
• Providers in Utuado, 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 Jan 12, 2024; 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.