Individual provider Active NPI

Florencio Lao Sam, M. D.

  • Physical Medicine & Rehabilitation Physician
  • Carolina, PR
National Provider Identifier
1295873222
Registry record updated Jan 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
6959 IN 1983 Issued in PR
Practice address
Carolina Shopp Ctr
Multipiso of 309 Ave 65 Infanteria
Carolina, PR 00985-5672
Phone
(787) 257-1840
Fax
(787) 701-4740
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 6959 IN 1983 PR Primary

Addresses

Primary practice location

Carolina Shopp Ctr
Multipiso of 309 Ave 65 Infanteria
Carolina, PR 00985-5672

Mailing address

138 Ave Winston Churchill PMB 228
San Juan, PR 00926-6013
Phone (787) 257-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110216001117 PR Practitioner - Physical Medicine and Rehabilitation 0042491581 Practice locations: Carolina, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
6959 IN 1983PRMDPhysical Medicine & Rehabilitation Physician

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296259200000",
    "number": "1295873222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 AVE WINSTON CHURCHILL PMB 228",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009266013",
            "telephone_number": "787-257-1840",
            "fax_number": "787-701-4740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAROLINA SHOPP CTR",
            "address_2": "MULTIPISO OF 309 AVE 65 INFANTERIA",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855672",
            "telephone_number": "787-257-1840",
            "fax_number": "787-701-4740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAO SAM",
        "first_name": "FLORENCIO",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "6959 IN 1983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carolina, PR

Sources for this page

Verify at the official NPI Registry.