CDT Hormigueros Preventive Medicine, Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

CDT HORMIGUEROS PREVENTIVE MEDICINE, INC

Practice address

Street 2 ,Munoz Marin
CDT Hormigueros
Hormigueros, PR 00660

Phone

(787) 382-2583

NPI assigned

Oct 7, 2011

Last updated

Oct 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jimmy Olivera

Title

Administrator

Phone

(787) 484-8273

Specialties & licenses 6

Addresses

Other names 1

• CDT HORMIGUEROS PREVENTIVE MEDICINE, INC. Former legal business name

Tax ID family

CDT Hormigueros Preventive Medicine Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• CDT Hormigueros Preventive Medicine, Inc

  • Health Service Clinic/Center
  • Hormigueros, PR
  • NPI 1093069122
  NPD tax ID
• CDT Hormigueros Preventive Medicine,Inc

  • Rural Acute Care Hospital
  • Hormigueros, PR
  • NPI 1427371145
  NPD tax ID

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1386928349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1550",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "006605550",
            "telephone_number": "787-484-8273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "STREET 2 ,MUNOZ MARIN",
            "address_2": "CDT HORMIGUEROS",
            "city": "HORMIGUEROS",
            "state": "PR",
            "postal_code": "00660",
            "telephone_number": "787-382-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDT HORMIGUEROS PREVENTIVE MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "OLIVERA",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-484-8273",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDT HORMIGUEROS PREVENTIVE MEDICINE, INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ananska M Carlo, MD
• Simon Enrique Carlo, M.D.
• Jose A Carrero, MD
• Yolanda Casiano, D.M.D.
• CDT Hormigueros Preventive Medicine, Inc
• CDT Hormigueros Preventive Medicine, Inc
• CDT Hormigueros Preventive Medicine,Inc
• Centro de Medicina Interna del Oeste, CSP
• Centro de Servicios Psicoeducativos del Oeste, Inc.
• Centro de Vacunacion Municipal

• General Practice Physician in Hormigueros, PR
• Providers in Hormigueros, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.