Clinica de Manejo del Dolor Dr Crawford W Long C S P

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

7701 Issued in PR

Legal business name

CLINICA DE MANEJO DEL DOLOR DR CRAWFORD W LONG C S P

Practice address

204 Calle Julio Cintron
Edificio Guayacan Suite 224
Aibonito, PR 00705

Phone

(787) 735-8900

Fax

(787) 735-3040

NPI assigned

Jun 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Eduardo Ibarra Ortega, M.D.

Title

Presidente

Phone

(787) 735-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

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

• Eduardo Ibarra, MD

  • Pain Medicine (Anesthesiology) Physician
  • Aibonito, PR
  • NPI 1871539932

  Pain Medicine, PR

  Medicare reassignment NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1326086232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "007051869",
            "telephone_number": "787-735-8900",
            "fax_number": "787-735-3040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CALLE JULIO CINTRON",
            "address_2": "EDIFICIO GUAYACAN SUITE 224",
            "city": "AIBONITO",
            "state": "PR",
            "postal_code": "00705",
            "telephone_number": "787-735-8900",
            "fax_number": "787-735-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DE MANEJO DEL DOLOR DR CRAWFORD W LONG C S P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "IBARRA",
        "authorized_official_title_or_position": "PRESIDENTE",
        "authorized_official_telephone_number": "787-735-8900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "PR",
            "license": "7701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PETAN",
            "identifier": "0082070",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centro Integral Multidiciplinario de Aibonito
• Centro Integral Multidiciplinario de Aibonito
• Centro Puma
• Carlos A Cepero Ayende, M.D.
• Clinica Cardiovascular de la Montana PSC
• Clinica Dental Rafael J.Gomez Matta PSC
• Clinica Oftalmica de la Montana, C.S.P.
• Clinica Todo Salud - Aibonito LLC
• Clinica Todo Salud - Aibonito, LLC
• Clinica Todo Salud - Aibonito, LLC

• All providers in Aibonito, PR
• Pain Medicine (Anesthesiology) Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.