Internal Medicine Professional Services, PSC

Primary specialty

Corporate Health Clinic/CenterTaxonomy code 261QC1800X

License

10015 Issued in PR

Legal business name

INTERNAL MEDICINE PROFESSIONAL SERVICES, PSC

Practice address

400 Ave Domenech Ste 408
Las Americas Professional Center
San Juan, PR 00918-3706

Phone

(787) 633-3615

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Angel R. Sepulveda, M.D.NPI 1841256823

Title

President

Phone

(787) 633-3615

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angel R. Sepulveda, M.D.

  • Specialist
  • San Juan, PR
  • NPI 1841256823
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114050879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10714",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009220714",
            "telephone_number": "787-633-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 AVE DOMENECH STE 408",
            "address_2": "LAS AMERICAS PROFESSIONAL CENTER",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183706",
            "telephone_number": "787-633-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE PROFESSIONAL SERVICES, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-633-3615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QC1800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Corporate Health",
            "state": "PR",
            "license": "10015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Corporate Health Clinic/Center in San Juan, PR
• Providers in San Juan, PR by specialty
• Corporate Health Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.