Doctoris Medical Group CSP

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DOCTORIS MEDICAL GROUP CSP

Practice address

Carr. PR 3 KM 1 HM 9
East Medical & Professional Center Suite
Canovas, PR 00729

Phone

(787) 256-5555

Fax

(787) 256-5454

NPI assigned

Jan 27, 2021

Last updated

Jan 27, 2021By 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

Mr. Edgar N Quintero Maldonado, MDNPI 1366402091

Title

President

Phone

(787) 256-5555

Specialties & licenses 5

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edgar N Quintero-Maldonado, M.D.

  • General Practice Physician
  • Canovanas, PR
  • NPI 1366402091
  Authorized official Same address or phone

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1154912723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "007292379",
            "telephone_number": "787-256-5555",
            "fax_number": "787-256-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. PR 3 KM 1 HM 9",
            "address_2": "EAST MEDICAL & PROFESSIONAL CENTER SUITE",
            "city": "CANOVAS",
            "state": "PR",
            "postal_code": "00729",
            "telephone_number": "787-256-5555",
            "fax_number": "787-256-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORIS MEDICAL GROUP CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "QUINTERO MALDONADO",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-256-5555",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.