NPIMap

Organization Active NPI

Laboratorio Clinico Plaza Caparra

  • Clinical Medical Laboratory
  • Guaynabo, PR
National Provider Identifier
1912335563
Registry record updated Feb 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1300 Issued in PR
Legal business name
LABORATORIO CLINICO PLAZA CAPARRA
Practice address
1498 Ave FD Roosevelt Ste 9a
Guaynabo, PR 00968-2735
Phone
(787) 941-4030
Fax
(787) 802-5555
NPI assigned
Oct 17, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2014

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

Authorized official

Name
Mr. Efrain Gonzalez
Title
Administrator
Phone
(787) 941-4030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1300 PR Primary

Addresses

Primary practice location

1498 Ave FD Roosevelt Ste 9a
Guaynabo, PR 00968-2735

Mailing address

PO Box 10985
San Juan, PR 00922-0985
Phone (787) 941-4030

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131220000476 PR Part B Supplier - Independent Clinical Laboratory 0840427779 Practice locations: Guaynabo, 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": "1381968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1912335563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10985",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009220985",
            "telephone_number": "787-941-4030",
            "fax_number": "787-802-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1498 AVE FD ROOSEVELT STE 9A",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009682735",
            "telephone_number": "787-941-4030",
            "fax_number": "787-802-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO PLAZA CAPARRA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-17",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "EFRAIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-941-4030",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.