Policlinica San Pedro PSC

Key facts

NPI

1003003484

Entity type

Organization (NPI type 2)

Primary specialty

Radiology Clinic/Center 261QR0200X

License

229 (PR)

Legal business name

POLICLINICA SAN PEDRO PSC

Practice address

211 Calle Morse
Arroyo, PR 00714-2350

Phone

(787) 839-3980

Fax

(787) 839-2515

NPI assigned

Sep 28, 2007

Organization subpart

No

Authorized official

Name

Laura C Rivera Irizarry

Title

Administrator

Phone

(787) 839-3980

Corporate family (same tax ID) 2

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

• Policlinica San Pedro PSC Clinical Medical Laboratory · Arroyo, PR · NPI 1285648022
  NPD tax ID
• Policlinica San Pedro PSC Emergency Care Clinic/Center · Arroyo, PR · NPI 1821070640
  NPD tax ID

National Provider Directory

Tax ID family

CDT Policlinica San Pedro (3 organizations share this tax ID)

Specialties & licenses

Addresses

Other identifiers

Other names

• CDT Policlinica San Pedro Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 19, 2017.

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1003003484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "007140818",
            "telephone_number": "787-839-3980",
            "fax_number": "787-839-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 CALLE MORSE",
            "city": "ARROYO",
            "state": "PR",
            "postal_code": "007142350",
            "telephone_number": "787-839-3980",
            "fax_number": "787-839-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLICLINICA SAN PEDRO PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "RIVERA IRIZARRY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-839-3980"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "PR",
            "license": "229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROSSAM",
            "identifier": "37394",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDT Policlinica San Pedro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arroyo, PR

• Yaika Berenice Ortiz
• Paradise River Corp
• Omar Perez Soto, MD
• Perfect Lens LLC
• Angel Antonio Picart
• Policlinica San Pedro PSC
• Policlinica San Pedro PSC
• Policlinica San Pedro Reforma
• Thelma Damaris Ramos Lassus, TDRL
• Itza Y Ramos-Anaya

All providers in Arroyo, PR · Radiology Clinic/Center in Puerto Rico