Servicios Medicos Profesionales Doctor J. Diaz CSP

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

12986 Issued in PR

Legal business name

SERVICIOS MEDICOS PROFESIONALES DOCTOR J. DIAZ CSP

Practice address

2 Calle Colon Ste 9
Aguada, PR 00602-3167

Phone

(787) 868-0045

Fax

(787) 868-0045

NPI assigned

Dec 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jamil Tareck Diaz Ruiz, MDNPI 1336106822

Title

President

Phone

(787) 244-7348

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamil Tareck Diaz Ruiz, M.D.

  • General Practice Physician
  • Aguada, PR
  • NPI 1336106822
  Medicare reassignment NPD Authorized official
• Ruth O Gonzalez, RD

  • Registered Dietitian
  • Aguada, PR
  • NPI 1689712697
  NPD (past)

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

{
    "created_epoch": "1165708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1275693574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CENTRO COOP",
            "address_2": "SUITE 5000 BOX 953",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006020953",
            "telephone_number": "787-868-0045",
            "fax_number": "787-868-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CALLE COLON STE 9",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006023167",
            "telephone_number": "787-868-0045",
            "fax_number": "787-868-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICIOS MEDICOS PROFESIONALES DOCTOR J. DIAZ CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-10",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "DIAZ RUIZ",
        "authorized_official_first_name": "JAMIL",
        "authorized_official_middle_name": "TARECK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-244-7348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "12986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCAL LICENSE",
            "identifier": "12986",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Manuel Serra Lopez
• Daniel Alexis Serrano, DC
• Serv Emerg del Noroeste
• Servicios Integrados de Salud Mental S.E.P.I.
• Servicios Medicos del Oeste
• Servicos Medicos Eqr CSP
• Servimed Absolute Care - Cap, Inc.
• Servimed Absolute Care-West, Inc.
• Luz A Sola
• Migdalis Soto Mendez

• General Practice Physician in Aguada, PR
• Providers in Aguada, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; 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.