NPIMap

Organization Active NPI

Bella Vista Policlinic, Inc

  • Medical Specialty Clinic/Center
  • Mayaguez, PR
National Provider Identifier
1205187697
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
200394 Issued in PR
Legal business name
BELLA VISTA POLICLINIC, INC
Practice address
Ave Hostos
Number 770
Mayaguez, PR 00681
Phone
(787) 652-6031
Fax
(787) 805-3705
NPI assigned
Sep 25, 2012
Organization subpart
Yes
Parent organization
BELLA VISTA POLICLINIC, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Authorized official

Name
Mr. Enrique Rivera, MBA
Title
Cfo
Phone
(787) 652-6031

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 200394 PR Primary

Addresses

Primary practice location

Ave Hostos
Number 770
Mayaguez, PR 00681

Mailing address

Ave Hostos
Number 770
Mayaguez, PR 00681
Phone (787) 652-6031

Other names 1

  • Bella Vista ENT Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
GRP Policlin Bella Vista4 organizations share this tax ID, including this one
Part of
GRP Policlin Bella Vista

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1205187697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AVE HOSTOS",
            "address_2": "NUMBER 770",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-652-6031",
            "fax_number": "787-805-3705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE HOSTOS",
            "address_2": "NUMBER 770",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "00681",
            "telephone_number": "787-652-6031",
            "fax_number": "787-805-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLA VISTA POLICLINIC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BELLA VISTA POLICLINIC, INC",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "RIVERA",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "787-652-6031",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PR",
            "license": "200394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bella Vista ENT Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.