Centro de Servicios de Reumatologia PSC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

8410 Issued in PR

Legal business name

CENTRO DE SERVICIOS DE REUMATOLOGIA PSC

Practice address

114 Calle Antonio Lopez S
Humacao, PR 00791-4249

Phone

(787) 850-6005

NPI assigned

Sep 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jorge A Mundo, M.D.NPI 1265593222

Title

Owner

Phone

(787) 850-6005

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

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

• Jorge A Mundo, MD

  • Rheumatology Physician
  • Humacao, PR
  • NPI 1265593222
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1417239336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1447",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771447",
            "telephone_number": "787-850-6005",
            "fax_number": "787-852-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CALLE ANTONIO LOPEZ S",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "007914249",
            "telephone_number": "787-850-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE SERVICIOS DE REUMATOLOGIA PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-16",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "MUNDO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-850-6005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PR",
            "license": "8410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Humacao, PR
• Providers in Humacao, PR by specialty
• Medical Specialty Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.