Active NPI
Joel Estrada Mangual
- Clinical Medical Laboratory
- Carolina, PR
National Provider Identifier
1811035959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 0936
- Legal business name
- JOEL ESTRADA MANGUAL
- Practice address
- Carretera 185 KM 12.6
Barrio Cedros
Carolina, PR 00985 - Phone
- (787) 776-2492
- NPI assigned
- Feb 1, 2007
- 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
- Joel Estrada, MT
- Title
- Owner
- Phone
- (787) 776-2492
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 0936 | PR | Primary |
Addresses
Primary practice location
Carretera 185 KM 12.6
Barrio Cedros
Carolina, PR 00985
Mailing address
Sabanera del Rio
Camino de Los Lirios 353
Gurabo, PR 00778
Phone (787) 744-2016
Other names 1
- LABORATORIO CLINICO CEDROS
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140319000376 | PR | Part B Supplier - Independent Clinical Laboratory | 6204067168 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Carolina, PR; Las Piedras, PR |
Other NPIs on the same Medicare enrollment 2
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Joel Estrada Mangual
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Arecibo, PR
- NPI 1053452888
-
- Clinical Medical Laboratory
- Las Piedras, PR
- NPI 1497897623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214265600000",
"number": "1811035959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "SABANERA DEL RIO",
"address_2": "CAMINO DE LOS LIRIOS 353",
"city": "GURABO",
"state": "PR",
"postal_code": "00778",
"telephone_number": "787-744-2016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CARRETERA 185 KM 12.6",
"address_2": "BARRIO CEDROS",
"city": "CAROLINA",
"state": "PR",
"postal_code": "00985",
"telephone_number": "787-776-2492"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOEL ESTRADA MANGUAL",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-01",
"last_updated": "2008-06-24",
"status": "A",
"authorized_official_last_name": "ESTRADA",
"authorized_official_first_name": "JOEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "787-776-2492",
"authorized_official_credential": "MT"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "PR",
"license": "0936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "LABORATORIO CLINICO CEDROS",
"code": "3",
"type": "Doing Business As"
}
]
}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 Jun 24, 2008; 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.