Individual provider Active NPI

Luis Ottoniel Latorre Castro

  • General Practice Physician
  • San Juan, PR
National Provider Identifier
1154814010
Registry record updated Apr 30, 2024
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Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
22030 Issued in PR
Practice address
Centro Medico Rio Piedras
Hospital Oncologico Dr I Gonzalez Martinez
San Juan, PR 00926
Phone
(787) 763-4149
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 22030 PR Primary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 14742I PR

Addresses

Primary practice location

Centro Medico Rio Piedras
Hospital Oncologico Dr I Gonzalez Martinez
San Juan, PR 00926

Mailing address

PO Box 191811 San Juan PR 00919-1811
San Juan, PR 00935-0001
Phone (787) 763-4149

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
I20201124001920 PR Practitioner - General Practice 4385055326 Practice locations: Caguas, PR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14742IPRMDGeneral Practice Physician
22030PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1154814010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191811 SAN JUAN PR 00919-1811",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009350001",
            "telephone_number": "787-763-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTRO MEDICO RIO PIEDRAS",
            "address_2": "HOSPITAL ONCOLOGICO DR I GONZALEZ MARTINEZ",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-763-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATORRE CASTRO",
        "first_name": "LUIS",
        "middle_name": "OTTONIEL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2024-04-30",
        "certification_date": "2020-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "22030",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "14742I",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.