Marisol Callazo Ortiz Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

746 Issued in PR

Legal business name

MARISOL CALLAZO ORTIZ INC

Doing business as

Laboratorio Clinico Microbiologico Puerto Rico

Practice address

Avenida Luis Munoz Marin #11
Cayey, PR 00736

Phone

(787) 738-7556

Fax

(787) 738-1515

NPI assigned

Jan 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Marisol Collazo, MS MT

Title

Lab Director

Phone

78773875556

Specialties & licenses 1

Addresses

Other identifiers 11

Other names 1

• Laboratorio Clinico Microbiologico Puerto Rico Doing business as

Tax ID family

Centro de Medicina Especializada2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Centro de Medicina Especializada

  • Emergency Care Clinic/Center
  • Cidra, PR
  • NPI 1952634800
  NPD tax ID

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922144609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1700",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "007371700",
            "telephone_number": "787-738-7556",
            "fax_number": "787-738-1515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA LUIS MUNOZ MARIN #11",
            "city": "CAYEY",
            "state": "PR",
            "postal_code": "00736",
            "telephone_number": "787-738-7556",
            "fax_number": "787-738-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARISOL CALLAZO ORTIZ INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLLAZO",
        "authorized_official_first_name": "MARISOL",
        "authorized_official_title_or_position": "LAB DIRECTOR",
        "authorized_official_telephone_number": "78773875556",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "746",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED MEDICARE CHOICE",
            "identifier": "20213",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLE S",
            "identifier": "30646",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA INSURANCE",
            "identifier": "6330044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA REFORMA",
            "identifier": "6330044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA HEALTH PLAN",
            "identifier": "6330044",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL MEDICAL CAR",
            "identifier": "0877",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED HEALTH UTI",
            "identifier": "400123",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMPR",
            "identifier": "15843",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN HEALTH",
            "identifier": "20463",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA CRUZ AZUL DE PUERTO RI",
            "identifier": "051387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UIA",
            "identifier": "LB00746",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laboratorio Clinico Microbiologico Puerto Rico",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• M R Reference Laboratories
• Celinette Malave Rivera
• Mar Billing
• Marangely Solivan (Jam Ambulance Service)
• Jose M. Marcial Suarez, M.D.
• Izamar Martes Roman, MD
• Miguel J Martin, DPM
• Miriam Martinez-Torres, M.D.
• Carmen Martinez, RN
• Esmeralda Vasquez Martinez

• Clinical Medical Laboratory in Cayey, PR
• Providers in Cayey, 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 Aug 22, 2020; 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.