NPIMap

Organization Active NPI

Family Health Clinic of Caribbean, Inc

  • General Practice Physician
  • Toa Alta, PR
National Provider Identifier
1205239589
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9462 Issued in PR
Legal business name
FAMILY HEALTH CLINIC OF CARIBBEAN, INC
Practice address
G 21 Calle 10
Villa Matilde
Toa Alta, PR 00953
Phone
(787) 870-7070
Fax
(787) 870-7852
NPI assigned
Oct 1, 2014
Last updated
Oct 1, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

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

Authorized official

Name
Ms. Itza D Chevres, MDNPI 1669413720
Title
President
Phone
(939) 645-0504

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 342726 CORP REGISTER PR
General Practice Physician 208D00000X 9462 PR Primary

Addresses

Primary practice location

G 21 Calle 10
Villa Matilde
Toa Alta, PR 00953

Mailing address

PO Box 867
Toa Alta, PUERTO RICO 00954
UM
Phone (787) 870-7852

Other identifiers 1

IdentifierTypeStateIssuer
342726OtherPRREGISTER CORPORATE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161212000158 PR Part B Supplier - Clinic/Group Practice 0244510105 Receives reassigned benefits from 3 practitioners
Practice locations: Toa Alta, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1205239589",
    "addresses": [
        {
            "country_code": "UM",
            "country_name": "United States Minor Outlying Islands",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "PO BOX 867",
            "city": "TOA ALTA",
            "state": "PUERTO RICO",
            "postal_code": "00954",
            "telephone_number": "787-870-7852",
            "fax_number": "787-870-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "G 21 CALLE 10",
            "address_2": "VILLA MATILDE",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "00953",
            "telephone_number": "787-870-7070",
            "fax_number": "787-870-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CLINIC OF CARIBBEAN, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "CHEVRES",
        "authorized_official_first_name": "ITZA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "939-645-0504",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "342726 CORP REGISTER",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "9462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTER CORPORATE NUMBER",
            "identifier": "342726",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Alta, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.