Esp Medical Group LLC
Organization Active NPI General Practice Physician · Lares, PR
NPI 1295591204 · NPPES record last updated Mar 2, 2024
Key facts
- NPI
- 1295591204
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Physician 208D00000X
- Legal business name
- ESP MEDICAL GROUP LLC
- Practice address
- Carr 135 KM 4.5
Castaner
Lares, PR 00669 - Phone
- (787) 829-5010
- NPI assigned
- Feb 27, 2024
- Organization subpart
- No
Authorized official
- Name
- Edgar Soto Perez, MD
- Title
- President
- Phone
- (787) 319-3905
Practitioners 1
-
Edgar Soto Perez, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240503001017 | PR | Part B Supplier - Clinic/Group Practice | 4486094778 |
Receives reassigned benefits from 1 practitioner Practice locations: Lares, PR |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician |
208D00000X | Yes |
Addresses
Primary practice location
Carr 135 KM 4.5
Castaner
Lares, PR 00669
Mailing address
HC 2 Box 6580
Lares, PR 00669-9715
Phone (787) 319-3905
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- Emmanuel Hospice Care, Incorporado
- Enid Haydee Acevedo Quinones
- Equipos Medicos de Lares, Inc.
- Eye Solution Optical Center LLC
- F.T. Clinical Laboratories,CSP
- F.T. Clinical Laboratories,Inc
- Farmacia CDT Lares Med Center
- Farmacia Cooperativa
All providers in Lares, PR · General Practice Physician in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.