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1053765354 NPI number — LABORATORIO CLINICO SAN JUAN INC

NPI Number: 1053765354
Health Care Provider/Practitioner: LABORATORIO CLINICO SAN JUAN INC

Information about “1053765354” NPI (LABORATORIO CLINICO SAN JUAN INC) exists in 1053765354 in HTML format HTML  |  1053765354 in plain Text format TXT  |  1053765354 in PDF (Portable Document Format) PDF  |  1053765354 in an XML format XML  formats.

NPI Number : 1053765354 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053765354",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LABORATORIO CLINICO SAN JUAN INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "JL-32 AVENIDA CARLOS JAVIER ANDALUZ",
    "SecondLineMailingAddress": "ROYAL PALM",
    "MailingAddressCityName": "BAYAMON",
    "MailingAddressStateName": "PR",
    "MailingAddressPostalCode": "00956-0000",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "787-756-7128",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "425 CARR 693 STE 1",
    "SecondLinePracticeLocationAddress": "PMB 132",
    "PracticeLocationAddressCityName": "DORADO",
    "PracticeLocationAddressStateName": "PR",
    "PracticeLocationAddressPostalCode": "00646-4817",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "787-554-4272",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/22/2016",
    "LastUpdateDate": "04/22/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ARRIETA",
    "AuthorizedOfficialFirstName": "CARMEN",
    "AuthorizedOfficialMiddleName": "L",
    "AuthorizedOfficialTitle": "PRESIDENTE",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "787-756-7128",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": "812",
        "LicenseNumberStateCode": "PR",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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