NPIMap

Organization Active NPI

San Lazargerd Medical II CSP

  • Diagnostic Radiology Physician
  • Lares, PR
National Provider Identifier
1063914729
Registry record updated Mar 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SAN LAZARGERD MEDICAL II CSP
Practice address
Carr 129 KM 21.2
Bo Callejones
Lares, PR 00669
Phone
(787) 897-0353
NPI assigned
Mar 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2018

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

Authorized official

Name
Geraldo Gonzalez, MD
Title
President
Phone
(787) 897-0560

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X PR Primary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X PR
Sonography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471S1302X PR
Vascular Sonography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471V0105X PR

Addresses

Primary practice location

Carr 129 KM 21.2
Bo Callejones
Lares, PR 00669

Mailing address

PO Box 428
Lares, PR 00669-0428
Phone (787) 897-0353

National Provider Directory

National Provider Directory
Tax ID family
San Lazargerd Medical II CSP3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1520467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520467200000",
    "number": "1063914729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690428",
            "telephone_number": "787-897-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 129 KM 21.2",
            "address_2": "BO CALLEJONES",
            "city": "LARES",
            "state": "PR",
            "postal_code": "00669",
            "telephone_number": "787-897-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LAZARGERD MEDICAL II CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-08",
        "last_updated": "2018-03-08",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GERALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-897-0560",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PR",
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": "PR",
            "license": null,
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "PR",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

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