Individual provider Active NPI

Maria Elena Nieves Muniz

  • Clinical Medical Laboratory
  • Aguadilla, PR
National Provider Identifier
1932188703
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1003 Issued in PR
Practice address
Carr No 2 KM 118.5 Bo Ceiba Baja
Aguadilla, PR 00603
Phone
(787) 882-1785
Fax
(787) 882-1785
NPI assigned
Jan 11, 2006
Last updated
May 15, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1003 PR Primary

Addresses

Primary practice location

Carr No 2 KM 118.5 Bo Ceiba Baja
Aguadilla, PR 00603

Mailing address

PO Box 3538
Aguadilla, PR 00605-3538
Phone (787) 882-1785

Other names 1

  • Dba Laboratorio Clinico Y Bacteriologico Ebenezer Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000277 PR Part B Supplier - Independent Clinical Laboratory 3274603717 Practice locations: Aguadilla, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1003PRMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1932188703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3538",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "006053538",
            "telephone_number": "787-882-1785",
            "fax_number": "787-658-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR NO 2 KM 118.5 BO CEIBA BAJA",
            "city": "AGUADILLA",
            "state": "PR",
            "postal_code": "00603",
            "telephone_number": "787-882-1785",
            "fax_number": "787-882-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEVES MUNIZ",
        "first_name": "MARIA",
        "middle_name": "ELENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "PR",
            "license": "1003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DBA LABORATORIO",
            "last_name": "Y BACTERIOLOGICO EBENEZER",
            "middle_name": "CLINICO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Aguadilla, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.