NPIMap

Organization Active NPI

Consultorio Medico Clinico Dr Gomez Adrover PSC

  • Primary Care Clinic/Center
  • Manati, PR
National Provider Identifier
1306126990
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
10351 Issued in PR
Legal business name
CONSULTORIO MEDICO CLINICO DR GOMEZ ADROVER PSC
Practice address
Carr 149 # Km1H3
Rept Villa Alberta 2
Manati, PR 00674-9670
Phone
(787) 854-6562
Fax
(787) 884-0253
NPI assigned
Aug 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Authorized official

Name
Dr. Reynaldo Gomez Adrover, MDNPI 1124025358
Title
President
Phone
(787) 854-6562

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 10351 PR Primary

Addresses

Primary practice location

Carr 149 # Km1H3
Rept Villa Alberta 2
Manati, PR 00674-9670

Mailing address

PO Box 414
Manati, PR 00674-0414
Phone (787) 854-6562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130730000447 PR Part B Supplier - Clinic/Group Practice 4486895703 Receives reassigned benefits from 2 practitioners
Practice locations: Manati, PR

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1306126990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 414",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006740414",
            "telephone_number": "787-854-6562",
            "fax_number": "787-884-0253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 149 # KM1H3",
            "address_2": "REPT VILLA ALBERTA 2",
            "city": "MANATI",
            "state": "PR",
            "postal_code": "006749670",
            "telephone_number": "787-854-6562",
            "fax_number": "787-884-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSULTORIO MEDICO CLINICO DR GOMEZ ADROVER PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "GOMEZ ADROVER",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-854-6562",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "10351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manati, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.