Laboratorio Clinico Aquarium Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

957 Issued in PR

Legal business name

LABORATORIO CLINICO AQUARIUM INC

Practice address

Carr 165 KM 4.7
Plaza Aquarium Shopping Mall
Toa Alta, PR 00953-8836

Phone

(787) 870-2101

Fax

(787) 870-2101

NPI assigned

Sep 21, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jolly Ortiz, MT

Title

Director

Phone

(787) 614-2131

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1922094473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "00646",
            "telephone_number": "787-870-2101",
            "fax_number": "787-870-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 165 KM 4.7",
            "address_2": "PLAZA AQUARIUM SHOPPING MALL",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009538836",
            "telephone_number": "787-870-2101",
            "fax_number": "787-870-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LABORATORIO CLINICO AQUARIUM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "JOLLY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-614-2131",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidlet, Inc.
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• La Plata Medical Group
• Miguel Angel La Torre Lopez, MD
• Lab Clinico Toa Alta Inc
• Laboratorio Clinico Caribe
• Laboratorio Clinico Central de Toa Alta Inc.
• Laboratorio Clinico del Toa
• Laboratorio Clinico Galiza Inc
• Laboratorio Clinico Galiza Inc

• Clinical Medical Laboratory in Toa Alta, PR
• Providers in Toa Alta, 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 Mar 4, 2024; 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.