Individual provider Active NPI

Candelario A Sosa, MD MPH

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1124026661
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9812 Issued in PR
Practice address
1306 Ave Fernandez Juncos
San Juan, PR 00909-2521
Phone
(787) 480-3000
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 9812 PR Primary

Addresses

Primary practice location

1306 Ave Fernandez Juncos
San Juan, PR 00909-2521

Mailing address

1306 Ave Fernandez Juncos
San Juan, PR 00909-2521
Phone (787) 480-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150302002076 PR Order and Referring Only - General PracticePractitioner - General Practice 3072839471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9812PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1124026661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 AVE FERNANDEZ JUNCOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092521",
            "telephone_number": "787-480-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1306 AVE FERNANDEZ JUNCOS",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092521",
            "telephone_number": "787-480-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOSA",
        "first_name": "CANDELARIO",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.