Puerto Rico Skin & Laser LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PUERTO RICO SKIN & LASER LLC

Practice address

525 Ave FD Roosevelt Ste 409
San Juan, PR 00918-8081

Phone

(787) 473-0073

NPI assigned

Aug 19, 2021

Last updated

Jun 26, 2023By 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

Miss Noelani E Gonzalez, MD,

Title

Owner

Phone

(787) 473-0073

Specialties & licenses 1

Addresses

Other identifiers 2

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, and the practitioner matching its NPPES authorized official.

• Noelani Gonzalez Ortiz, M.D.

  • Dermatology Physician
  • San Juan, PR
  • NPI 1255607222
  Medicare reassignment NPD
• Sergio M Alegre-Boschetti, MD

  • Clinical Cardiac Electrophysiology Physician
  • Brooklyn, NY
  • NPI 1376074534
  NPD (past)

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1285300251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 AVE CARLOS CHARDON STE 133",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009181721",
            "telephone_number": "787-473-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 AVE FD ROOSEVELT STE 409",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009188081",
            "telephone_number": "787-473-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICO SKIN & LASER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "NOELANI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-473-0073",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "MD,"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRO DE COMERCIANTE",
            "identifier": "1187256-0010",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF ORGANIZATION",
            "identifier": "446563",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Puerto Rico Metropolitan Urology LLC
• Puerto Rico Orthopedic Sports Medicine LLC
• Puerto Rico Pathology Associates P
• Puerto Rico Pediatric Surgery Group PSC
• Puerto Rico Perfusion Inc.
• Puerto Rico Therapy Group, Inc
• Puerto Rico Vascular Access Center PSC
• Gisela D Puig Carrion, M.D.
• Vanessa Puig Mattei
• Lyann Marie Puig Quinones, DMD

• Dermatology Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Dermatology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.