Clinica de Urologia Reconstructiva

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

12551 Issued in PR

Legal business name

CLINICA DE UROLOGIA RECONSTRUCTIVA

Practice address

Gautier Benitez Ave.
Suite C20-a
Caguas, PR 00725

Phone

(787) 704-4141

Fax

(787) 704-4144

NPI assigned

Aug 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marcial A Walker, M.D.NPI 1811959158

Title

President

Phone

(787) 704-4141

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.

• Marcial A. Walker, M.D.

  • Urology Physician
  • Caguas, PR
  • NPI 1811959158
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188345600000",
    "number": "1194919589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GAUTIER BENITEZ AVE",
            "address_2": "SUITE C20-A",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007256539",
            "telephone_number": "787-704-4141",
            "fax_number": "787-704-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GAUTIER BENITEZ AVE.",
            "address_2": "SUITE C20-A",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "00725",
            "telephone_number": "787-704-4141",
            "fax_number": "787-704-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE UROLOGIA RECONSTRUCTIVA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2007-08-29",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "MARCIAL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-704-4141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "PR",
            "license": "12551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Urology Physician in Caguas, PR
• Providers in Caguas, PR by specialty
• Urology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; 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.