NPIMap

Organization Active NPI

Luquillo- Opd

  • Multi-Specialty Clinic/Center
  • Luquillo, PR
National Provider Identifier
1043964141
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LUQUILLO- OPD
Practice address
Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773
Phone
(787) 885-4446
Fax
(787) 885-6129
NPI assigned
Feb 8, 2022
Last updated
Feb 8, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PUERTO RICO PRIMARY CARE MSO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Keila Centeno
Title
Administrator
Phone
(787) 534-3789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

Calle 14 de Julio No 159
Bo Mata de Platano
Luquillo, PR 00773

Mailing address

PO Box 818
Ceiba, PR 00735-0818
Phone (787) 534-3789

National Provider Directory

National Provider Directory
Tax ID family
Puerto Rico Primary Care Mso Inc - CDT Luquillo4 organizations share this tax ID, including this one
Part of
Puerto Rico Primary Care Mso Inc - CDT Luquillo

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1043964141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 818",
            "city": "CEIBA",
            "state": "PR",
            "postal_code": "007350818",
            "telephone_number": "787-534-3789",
            "fax_number": "787-885-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE 14 DE JULIO NO 159",
            "address_2": "BO MATA DE PLATANO",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-885-4446",
            "fax_number": "787-885-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUQUILLO- OPD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PUERTO RICO PRIMARY CARE MSO, INC.",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "CENTENO",
        "authorized_official_first_name": "KEILA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-534-3789"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Luquillo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.