Grupo Medico Jatibonico LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GRUPO MEDICO JATIBONICO LLC

Practice address

65 Calle Pedro Rosario
Aibonito, PR 00705-3237

Phone

(787) 625-2500

Fax

(787) 625-0438

NPI assigned

May 22, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Joaquin A Feliciano Sr.

Title

Administrator

Phone

(787) 625-2500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1013408459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. CARIBE 1551",
            "address_2": "CALLE ALDA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-625-2500",
            "fax_number": "787-625-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CALLE PEDRO ROSARIO",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007053237",
            "telephone_number": "787-625-2500",
            "fax_number": "787-625-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO MEDICO JATIBONICO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "FELICIANO",
        "authorized_official_first_name": "JOAQUIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-625-2500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Ines Gonzalez, T.S.
• Maria D Gonzalez
• Isadora Zaira Gonzalezrosario, DMD
• Sandra C. Gracia-Lopez, M.D.
• Anabel Gracia, PSYCHOLOGIST
• Grupo Medico Menonita
• Guayacan Visual Care Management Inc
• Jose R Gutierrez Colon
• Carlos Javier Guzman Ortiz, MD
• Hall of Life Ambulance LLC

• All providers in Aibonito, PR
• Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.