NPIMap

Organization Active NPI

Laboratorio Angel Jelly Goyco

  • Clinical Medical Laboratory
  • Mayaguez, PR
National Provider Identifier
1811956345
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
469 Issued in PR
Legal business name
LABORATORIO ANGEL JELLY GOYCO
Doing business as
Laboratorio Angel Jelly Goyco
Practice address
22 N Calle Dr Basora
Mayaguez, PR 00680-0001
Phone
(787) 833-6020
Fax
(787) 833-6020
NPI assigned
Mar 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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

Authorized official

Name
Luis E Segarra, M.T.
Title
Owner
Phone
(787) 833-6020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 469 PR Primary

Addresses

Primary practice location

22 N Calle Dr Basora
Mayaguez, PR 00680-0001

Mailing address

PO Box 3070
Mayaguez, PR 00681-3070
Phone (787) 833-6020

Other names 1

  • Laboratorio Angel Jelly Goyco Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396828800000",
    "number": "1811956345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3070",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006813070",
            "telephone_number": "787-833-6020",
            "fax_number": "787-833-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N CALLE DR BASORA",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006800001",
            "telephone_number": "787-833-6020",
            "fax_number": "787-833-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO ANGEL JELLY GOYCO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2014-04-07",
        "status": "A",
        "authorized_official_last_name": "SEGARRA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-833-6020",
        "authorized_official_credential": "M.T."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Angel Jelly Goyco",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; 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.