Active NPI
Laboratorio Clinico Jollymar Inc
- Clinical Medical Laboratory
- Dorado, PR
National Provider Identifier
1750935904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- LABORATORIO CLINICO JOLLYMAR INC
- Practice address
- Carr 695 KM 2.0 Urb Doraville 1
Dorado, PR 00646 - Phone
- (787) 717-7113
- Fax
- (787) 717-4838
- NPI assigned
- Jul 26, 2019
- 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
- Jolly Ortiz
- Title
- President
- Phone
- (787) 797-5700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
Carr 695 KM 2.0 Urb Doraville 1
Dorado, PR 00646
Mailing address
PO Box 970
Dorado, PR 00646
Phone (787) 717-7113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191025000074 | PR | Part B Supplier - Independent Clinical Laboratory | 9234213687 | Practice locations: Dorado, PR |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Lab Clin Jollymar
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Toa Alta, PR
- NPI 1194711648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1709510400000",
"number": "1750935904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-717-7113",
"fax_number": "787-717-4838"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARR 695 KM 2.0 URB DORAVILLE 1",
"city": "DORADO",
"state": "PR",
"postal_code": "00646",
"telephone_number": "787-717-7113",
"fax_number": "787-717-4838"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LABORATORIO CLINICO JOLLYMAR INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-26",
"last_updated": "2024-03-04",
"certification_date": "2024-03-04",
"status": "A",
"authorized_official_last_name": "ORTIZ",
"authorized_official_first_name": "JOLLY",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "787-797-5700"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorado, PR
- Kyrohealthpc
- L & a Doctors LLC
- Laboratorio Clinico Dorado Inc
- Laboratorio Clinico Doramar Plaza de Dorado Inc
- Laboratorio Clinico Espinosa Inc
- Laboratorio Clinico Kikita LLC
- Laboratorio Clinico Laracuente
- Laboratorio Clinico Los Puertos Inc.
- Laboratorio Clinico San Juan Inc
- Laboratorio Genesis del Dorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.