Active NPI
Medivida
- Family Medicine Physician
- San Juan, PR
National Provider Identifier
1043700743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- MEDIVIDA
- Practice address
- 407B Calle Juan a Davila
Suite 2
San Juan, PR 00918 - Phone
- (787) 504-5005
- NPI assigned
- May 17, 2018
- Last updated
- May 17, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Heileene Torres Colberg
- Title
- Partner
- Phone
- (787) 396-5050
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| General Practice Physician | 208D00000X |
Addresses
Primary practice location
407B Calle Juan a Davila
Suite 2
San Juan, PR 00918
Mailing address
PO Box 16474
San Juan, PR 00908-6474
Phone (787) 396-5050
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Guaynabo, PR
- NPI 1841593316
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1526515200000",
"number": "1043700743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16474",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009086474",
"telephone_number": "787-396-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407B CALLE JUAN A DAVILA",
"address_2": "SUITE 2",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "00918",
"telephone_number": "787-504-5005"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDIVIDA",
"organizational_subpart": "NO",
"enumeration_date": "2018-05-17",
"last_updated": "2018-05-17",
"status": "A",
"authorized_official_last_name": "TORRES COLBERG",
"authorized_official_first_name": "HEILEENE",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "787-396-5050",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.