NPIMap

Organization Active NPI

The Mayaguez Clinic LLC

  • Specialist
  • Toa Baja, PR
National Provider Identifier
1255731022
Registry record updated Aug 29, 2014
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Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
THE MAYAGUEZ CLINIC LLC
Practice address
# 600 Avenida Comerio Norte
A la Orden Shopping Center
Toa Baja, PR 00950-1502
Phone
(787) 710-2532
Fax
(939) 202-7294
NPI assigned
Aug 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Dr. Otegbola Ojo, M.D.
Title
President
Phone
(787) 710-2532

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

# 600 Avenida Comerio Norte
A la Orden Shopping Center
Toa Baja, PR 00950-1502

Mailing address

PO Box 51502
Toa Baja, PR 00950-1502
Phone (787) 710-2532

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1255731022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51502",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009501502",
            "telephone_number": "787-710-2532",
            "fax_number": "939-202-7294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "# 600 AVENIDA COMERIO NORTE",
            "address_2": "A LA ORDEN SHOPPING CENTER",
            "city": "TOA BAJA",
            "state": "PR",
            "postal_code": "009501502",
            "telephone_number": "787-710-2532",
            "fax_number": "939-202-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MAYAGUEZ CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "OJO",
        "authorized_official_first_name": "OTEGBOLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-710-2532",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toa Baja, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.