Organization Active NPI

Lisbeth Lugo Sr

  • Clinical Medical Laboratory
  • Guanica, PR
National Provider Identifier
1912300617
Registry record updated Nov 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
LISBETH LUGO SR
Practice address
Carr 116 KM 24.7
Centro Comercial Plaza Guanica Suite 6 Bo Cano
Guanica, PR 00653
Phone
(787) 216-9287
Fax
(787) 848-0318
NPI assigned
Oct 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2014

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

Authorized official

Name
Ms. Lisbeth Lugo Nieves, MT
Title
Owner/Supervisor
Phone
(787) 216-9287

Specialties & licenses 1

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

Addresses

Primary practice location

Carr 116 KM 24.7
Centro Comercial Plaza Guanica Suite 6 Bo Cano
Guanica, PR 00653

Mailing address

HC 1 Box 6211
Yauco, PR 00698-9741
Phone (787) 216-9287

Other names 1

  • Laboratorio Clinico La 116 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150108002103 PR Part B Supplier - Independent Clinical Laboratory 8628391190 Practice locations: Guanica, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414972800000",
    "number": "1912300617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 1 BOX 6211",
            "city": "YAUCO",
            "state": "PR",
            "postal_code": "006989741",
            "telephone_number": "787-216-9287",
            "fax_number": "787-848-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 116 KM 24.7",
            "address_2": "CENTRO COMERCIAL PLAZA GUANICA SUITE 6 BO CANO",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "00653",
            "telephone_number": "787-216-9287",
            "fax_number": "787-848-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISBETH LUGO SR",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-11-03",
        "status": "A",
        "authorized_official_last_name": "LUGO NIEVES",
        "authorized_official_first_name": "LISBETH",
        "authorized_official_title_or_position": "OWNER/SUPERVISOR",
        "authorized_official_telephone_number": "787-216-9287",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico La 116",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Guanica, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; 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.