NPIMap

Organization Active NPI

Grupo Medico San Carlos

  • Clinic/Center
  • San Juan, PR
National Provider Identifier
1356506844
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
09-B-3148 Issued in PR
Legal business name
GRUPO MEDICO SAN CARLOS
Practice address
1866 Ave Ponce de Leon
San Juan, PR 00909-2010
Phone
(787) 268-4433
Fax
(787) 726-1828
NPI assigned
Jul 23, 2008
Last updated
Sep 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Mrs. Daisy Villa
Title
Administrator
Phone
(787) 268-4433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 09-B-3148 PR Primary

Addresses

Primary practice location

1866 Ave Ponce de Leon
San Juan, PR 00909-2010

Mailing address

Box 19209
Fdez Juncos Station
San Juan, PR 00910-1209
Phone (787) 268-4433

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1356506844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 19209",
            "address_2": "FDEZ JUNCOS STATION",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009101209",
            "telephone_number": "787-268-4433",
            "fax_number": "787-726-1828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 AVE PONCE DE LEON",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009092010",
            "telephone_number": "787-268-4433",
            "fax_number": "787-726-1828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRUPO MEDICO SAN CARLOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "DAISY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-268-4433",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "09-B-3148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

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