Organization Active NPI

Lab. Clinico Carraizo

  • Clinical Medical Laboratory
  • San Juan, PR
National Provider Identifier
1790848554
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
918 Issued in PR
Legal business name
LAB. CLINICO CARRAIZO
Practice address
Carr 844 KM 5.6
Bo. Carraizo
San Juan, PR 00926
Phone
(787) 755-5060
Fax
(787) 755-5060
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Authorized official

Name
Neftali Toledo
Title
Administrator
Phone
(787) 755-5060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 918 PR Primary

Addresses

Primary practice location

Carr 844 KM 5.6
Bo. Carraizo
San Juan, PR 00926

Mailing address

Urb Riachuelo
Ro 8 Calle Plaza Este
Trujillo Alto, PR 00976
Phone (787) 755-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000148 PR Part B Supplier - Independent Clinical Laboratory 2668557828 Practice locations: Trujillo Alto, PR

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561680000000",
    "number": "1790848554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB RIACHUELO",
            "address_2": "RO 8 CALLE PLAZA ESTE",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-755-5060",
            "fax_number": "787-946-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 844 KM 5.6",
            "address_2": "BO. CARRAIZO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-755-5060",
            "fax_number": "787-755-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB. CLINICO CARRAIZO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2019-06-28",
        "status": "A",
        "authorized_official_last_name": "TOLEDO",
        "authorized_official_first_name": "NEFTALI",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-755-5060"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2019; 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.