Individual provider Active NPI

Jose Armando Corzo Gomez, MD

  • Student in an Organized Health Care Education/Training Program
  • San Juan, PR
National Provider Identifier
1255942074
Registry record updated Aug 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
15611-I Issued in PR
Practice address
715 Ave Ponde de Leon Stop 37.5
San Juan, PR 00918
Phone
(787) 758-2000
NPI assigned
Aug 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 15611-I PR Primary

Addresses

Primary practice location

715 Ave Ponde de Leon Stop 37.5
San Juan, PR 00918

Mailing address

11575 City Hall Promenade Unit 359
Miramar, FL 33025-7594
Phone (954) 702-9454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15611-IPRMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: jose.corzogomez.p1@direct.vivamasmedical.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597363200000",
    "number": "1255942074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11575 CITY HALL PROMENADE UNIT 359",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330257594",
            "telephone_number": "954-702-9454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 AVE PONDE DE LEON STOP 37.5",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00918",
            "telephone_number": "787-758-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORZO GOMEZ",
        "first_name": "JOSE",
        "middle_name": "ARMANDO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-14",
        "last_updated": "2020-08-14",
        "certification_date": "2020-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "15611-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 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.