Individual provider Active NPI

Maritza Vega-Rodriguez, MD

  • General Acute Care Hospital
  • San Juan, PR
National Provider Identifier
1023139748
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
25 Issued in PR
Practice address
Hospital Industrial-Centro Medico
Bo. Monacillos
San Juan, PR 00936
Phone
(787) 754-2525
Fax
(787) 767-3968
NPI assigned
Apr 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 25 PR Primary

Addresses

Primary practice location

Hospital Industrial-Centro Medico
Bo. Monacillos
San Juan, PR 00936

Mailing address

PO Box 70344
PMB 358
San Juan, PR 00936-8344
Phone (787) 761-4948

Other identifiers 3

IdentifierTypeStateIssuer
AV 8934956OtherFEDERAL NARCOTICS LICENSE
04435DM-4OtherPRNARCOTICS STATE LICENSE
5475OtherPRSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230104003188 FL Order and Referring Only - General SurgeryPractitioner - General Surgery 9537539747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5475PRMDPharmacist
25PRMDGeneral Acute Care Hospital

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023139748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70344",
            "address_2": "PMB 358",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009368344",
            "telephone_number": "787-761-4948",
            "fax_number": "787-767-3968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HOSPITAL INDUSTRIAL-CENTRO MEDICO",
            "address_2": "BO. MONACILLOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00936",
            "telephone_number": "787-754-2525",
            "fax_number": "787-767-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA-RODRIGUEZ",
        "first_name": "MARITZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "PR",
            "license": "25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL NARCOTICS LICENSE",
            "identifier": "AV 8934956",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NARCOTICS STATE LICENSE",
            "identifier": "04435DM-4",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5475",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.