Centro Dermatologico San Pablo, PSC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CENTRO DERMATOLOGICO SAN PABLO, PSC

Practice address

Calle Santa Cruz #68 Torre San Pablo
Suite 306
Bayamon, PR 00959

Phone

(787) 798-1200

Fax

(787) 740-1200

NPI assigned

Jan 11, 2006

Organization subpart

No

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

Authorized official

Name

Luis J. Ortiz-Espinosa, M.D., FAADNPI 1053390732

Title

Medical Director

Phone

(787) 740-0564

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 5

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

• Luis J Ortiz-Espinosa, M.D., FAAD

  • Dermatology Physician
  • Carolina, PR
  • NPI 1053390732
  Medicare reassignment NPD Authorized official
• Estefania Cruzval O'Reilly, MD

  • Dermatology Physician
  • Bayamon, PR
  • NPI 1083239214
  Medicare reassignment NPD
• Axel R Delgado, MD

  • Dermatology Physician
  • Dorado, PR
  • NPI 1457850570
  Medicare reassignment
• Eneida Maria De la Torre - Lugo, M.D.

  • Dermatology Physician
  • Bayamon, PR
  • NPI 1467603027
  NPD (past)
• Marely Santiago Vazquez, MD

  • Dermatology Physician
  • Palmas del Mar, Humacao, PR
  • NPI 1144776865
  NPD (past)

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1194704882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVENIDA 90",
            "address_2": "PMB SUITE 126",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-798-1200",
            "fax_number": "787-740-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SANTA CRUZ #68 TORRE SAN PABLO",
            "address_2": "SUITE 306",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00959",
            "telephone_number": "787-798-1200",
            "fax_number": "787-740-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DERMATOLOGICO SAN PABLO, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "ORTIZ-ESPINOSA",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "787-740-0564",
        "authorized_official_credential": "M.D., FAAD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.