Grupo Medico Ipa 555

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

GRUPO MEDICO IPA 555

Practice address

Calle San Francisco 405
Suite 2-C
San Juan, PR 00902

Phone

(787) 721-0279

Fax

(787) 721-0279

NPI assigned

May 17, 2007

Last updated

Aug 22, 2020By 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

Dr. Rafael Luzardo, M.D.

Title

Administrator

Phone

(787) 721-0279

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235346438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9023558",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009023558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SAN FRANCISCO 405",
            "address_2": "SUITE 2-C",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00902",
            "telephone_number": "787-721-0279",
            "fax_number": "787-721-0279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO MEDICO IPA 555",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUZARDO",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-721-0279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in San Juan, PR
• Providers in San Juan, PR by specialty
• Health Maintenance Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.