La Vida Medical Group Hatillo PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

707 Issued in PR

Legal business name

LA VIDA MEDICAL GROUP HATILLO PT

Practice address

549 Calle del Mar
Suite 304
Hatillo, PR 00659-2869

Phone

(787) 878-8802

Fax

(787) 881-4312

NPI assigned

Apr 7, 2008

Last updated

Apr 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Diana I Matos

Title

Billing Manager

Phone

(787) 878-8155

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1073786547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 CALLE DEL MAR",
            "address_2": "SUITE 304",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592869",
            "telephone_number": "787-878-8802",
            "fax_number": "787-881-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 CALLE DEL MAR",
            "address_2": "SUITE 304",
            "city": "HATILLO",
            "state": "PR",
            "postal_code": "006592869",
            "telephone_number": "787-878-8802",
            "fax_number": "787-881-4312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VIDA MEDICAL GROUP HATILLO PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "MATOS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "787-878-8155",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JL Gonzalez Rodriguez LLC
• Hector Juarbe, M.D.
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• La Vida Medical Group Hatillo Corp
• La Vida Medical Group Hatillo Corp (Laboratorio Clinico Los Angeles Medical Group)
• La Vida Medical Group PSC
• Lab Clinico CDT Dr Ferdinando Maldonado
• Laboratorio Clinic Omaris Inc
• Laboratorio Clinic Omaris, Inc (Laboratorio Clinico y Bacteriologico Omarys)
• Laboratorio Clinico del Bo. Corcobada, Inc.

• Physical Medicine & Rehabilitation Physician in Hatillo, PR
• Providers in Hatillo, PR by specialty
• Physical Medicine & Rehabilitation Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; 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.