NPIMap

Organization Active NPI

CDT Hormigueros Preventive Medicine, Inc

  • Health Service Clinic/Center
  • Hormigueros, PR
National Provider Identifier
1093069122
Registry record updated Oct 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
32 Issued in PR
Legal business name
CDT HORMIGUEROS PREVENTIVE MEDICINE, INC
Practice address
2 Munoz Rivera Street
Hormigueros, PR 00660-0000
Phone
(787) 935-7103
Fax
(787) 935-7301
NPI assigned
Oct 26, 2012
Last updated
Oct 26, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2012

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

Authorized official

Name
Mr. Jimmy Olivera Jaume
Title
Administrador
Phone
(787) 484-8273

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 32 PR Primary

Addresses

Primary practice location

2 Munoz Rivera Street
Hormigueros, PR 00660-0000

Mailing address

PO Box 1550
Hormigueros, PR 00660-5550
Phone (787) 935-7103

Other identifiers 2

IdentifierTypeStateIssuer
9278-12OtherPRLIC PRODUCTOS BIOLOGICOS
14-B-5586OtherPRLIC BOTIQUIN

National Provider Directory

National Provider Directory
Tax ID family
CDT Hormigueros Preventive Medicine Inc3 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": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351209600000",
    "number": "1093069122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006605550",
            "telephone_number": "787-935-7103",
            "fax_number": "787-935-7301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MUNOZ RIVERA STREET",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006600000",
            "telephone_number": "787-935-7103",
            "fax_number": "787-935-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDT HORMIGUEROS PREVENTIVE MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2012-10-26",
        "status": "A",
        "authorized_official_last_name": "OLIVERA JAUME",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "ADMINISTRADOR",
        "authorized_official_telephone_number": "787-484-8273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "PR",
            "license": "32",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC PRODUCTOS BIOLOGICOS",
            "identifier": "9278-12",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC BOTIQUIN",
            "identifier": "14-B-5586",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hormigueros, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; 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.