NPIMap

Organization Active NPI

Servicios Medicos Integrados de Fajardo, P.S.C.

  • Community Health Clinic/Center
  • Rio Grande, PR
National Provider Identifier
1407581440
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C.
Practice address
Calle Manuel Pimentel Y Castro (CDT Rio Grande)
200
Rio Grande, PR 00745-3000
Phone
(939) 290-9093
Fax
(787) 988-7788
NPI assigned
Jul 22, 2022
Organization subpart
Yes
Parent organization
SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Authorized official

Name
Dr. Agapito Fontanez, MD
Title
Director
Phone
(787) 863-7646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

Calle Manuel Pimentel Y Castro (CDT Rio Grande)
200
Rio Grande, PR 00745-3000

Mailing address

PO Box 827
Fajardo, PR 00738-0827
Phone (787) 863-7646

Other names 2

  • CENTRO DE VACUNACION RIO GRANDE 5138 Doing business as
  • SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C. VACUNACION 5138 Other name

National Provider Directory

National Provider Directory
Tax ID family
Servicios Medicos Integrados de Fajardo PSC5 organizations share this tax ID, including this one
Part of
Servicios Medicos Integrados de Fajardo PSC

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1407581440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 827",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007380827",
            "telephone_number": "787-863-7646",
            "fax_number": "787-988-7788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE MANUEL PIMENTEL Y CASTRO (CDT RIO GRANDE)",
            "address_2": "200",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "007453000",
            "telephone_number": "939-290-9093",
            "fax_number": "787-988-7788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C.",
        "enumeration_date": "2022-07-22",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "FONTANEZ",
        "authorized_official_first_name": "AGAPITO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "787-863-7646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTRO DE VACUNACION RIO GRANDE 5138",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SERVICIOS MEDICOS INTEGRADOS DE FAJARDO, P.S.C. VACUNACION 5138",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rio Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.