Lab Clinico Lomas Verdes Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

276 Issued in PR

Legal business name

LAB CLINICO LOMAS VERDES INC

Practice address

1353 Rd 19 PMB 423
Guaynabo, PR 00966-2700

Phone

(787) 787-7417

Fax

(787) 780-9220

NPI assigned

Mar 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Milagros Ivelisse Perez

Title

Presidenta

Phone

(787) 413-7090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

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

{
    "created_epoch": "1141603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1881661189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "Z39 AVE LAUREL",
            "address_2": "LOMAS VERDES",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009563244",
            "telephone_number": "787-787-7417",
            "fax_number": "787-780-9220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 RD 19 PMB 423",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662700",
            "telephone_number": "787-787-7417",
            "fax_number": "787-780-9220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAB CLINICO LOMAS VERDES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-06",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "MILAGROS",
        "authorized_official_middle_name": "IVELISSE",
        "authorized_official_title_or_position": "PRESIDENTA",
        "authorized_official_telephone_number": "787-413-7090",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery J Knapp Jr., M.D.
• Cynthia Elizabeth Knighton, MS., CCC-SLP
• Karla Yvonne Kramer de Courceuil, PSY.D
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• Laboratorio Clinico del Pueblo Inc

• Clinical Medical Laboratory in Guaynabo, PR
• Providers in Guaynabo, 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 Nov 27, 2012; 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.