Prepven Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PREPVEN CORP

Practice address

315 Calle Manuel Domenech Ste 1
San Juan, PR 00918-3513

Phone

(787) 918-8618

NPI assigned

Jul 12, 2020

Organization subpart

No

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

Authorized official

Name

Ronald Collazo Pagan, MD

Title

Director

Phone

(787) 918-8618

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1594512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641772800000",
    "number": "1366060766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 AVE MANUEL DOMENECH STE 1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183513",
            "telephone_number": "787-918-8618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 CALLE MANUEL DOMENECH STE 1",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009183513",
            "telephone_number": "787-918-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREPVEN CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-12",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A",
        "authorized_official_last_name": "COLLAZO PAGAN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-918-8618",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039197200",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in San Juan, PR
• Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; 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.