Dr Heredia Medical Service

Primary specialty

SpecialistTaxonomy code 174400000X

License

14360 Issued in PR

Legal business name

DR HEREDIA MEDICAL SERVICE

Practice address

30 Calle Baldorioty
Morovis , PR 00687
Morovis, PR 00687-3111

Phone

(787) 862-3939

Fax

(787) 862-3939

NPI assigned

Jun 3, 2009

Last updated

Jun 3, 2009By 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. Carlos Manuel Heredia, M.D

Title

President

Phone

(787) 862-3939

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1255567319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CALLE BALDORIOTY",
            "address_2": "MOROVOVIS, PR 00687",
            "city": "MOROVIS",
            "state": "PR",
            "postal_code": "006873111",
            "telephone_number": "787-862-3939",
            "fax_number": "787-862-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CALLE BALDORIOTY",
            "address_2": "MOROVIS , PR 00687",
            "city": "MOROVIS",
            "state": "PR",
            "postal_code": "006873111",
            "telephone_number": "787-862-3939",
            "fax_number": "787-862-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR HEREDIA MEDICAL SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "HEREDIA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "MANUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-862-3939",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "14360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Morovis, PR
• Providers in Morovis, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.