Roosevelt Pediatric Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ROOSEVELT PEDIATRIC GROUP

Practice address

576 Calle Cesar Gonzalez
Suite 404
San Juan, PR 00918-3756

Phone

(787) 753-1097

Fax

(787) 764-3927

NPI assigned

Apr 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Marco Antonio Perez-Davila, M.D.NPI 1447213756

Title

Senior Partner

Phone

(787) 753-1097

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Marco Antonio Perez-Davila, M.D.

  • Pediatrics Physician
  • San Juan, PR
  • NPI 1447213756
  NPD (past) Authorized official
• Daniela Maria Albors-Agullo, MD

  • Pediatrics Physician
  • San Juan, PR
  • NPI 1528625076
  NPD (past)
• Iona Krystin Malinow-Maceo, M.D.

  • Pediatric Allergy/Immunology Physician
  • Bayamon, PR
  • NPI 1821186875

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1336101112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 CALLE CESAR GONZALEZ",
            "address_2": "SUITE 404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183756",
            "telephone_number": "787-753-1097",
            "fax_number": "787-764-3927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 CALLE CESAR GONZALEZ",
            "address_2": "SUITE 404",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183756",
            "telephone_number": "787-753-1097",
            "fax_number": "787-764-3927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT PEDIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "PEREZ-DAVILA",
        "authorized_official_first_name": "MARCO",
        "authorized_official_middle_name": "ANTONIO",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "787-753-1097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Angel Ronda Rodriguez, MD
• Wandalisse Ronda, M.A.
• Raul Rondon de Jesus, P.T.
• Keviany Rondon Pagan, M.S SLP
• Hector Teodoro Rondon, MD
• Rootcanals to Go PSC
• Luis Fernando Roque Colon, LCSW
• Alexandra Marlisse Roque Saldana, MD
• Jose Roque Torres, MD
• Diana Roque

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.