NPIMap

Organization Active NPI

Centro de Salud de Lares, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lares, PR
National Provider Identifier
1417907502
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
CNC99-285 Issued in PR
Legal business name
CENTRO DE SALUD DE LARES, INC.
Practice address
Road 111 KM 1.9
Los Patriotas Ave.
Lares, PR 00669-0379
Phone
(787) 897-2727
Fax
(787) 897-2725
NPI assigned
May 11, 2006
Last updated
Apr 27, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRO DE SALUD DE LARES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Authorized official

Name
Damaris Rodriguez
Title
Executive Director
Phone
(787) 897-2727

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CNC99-285 PR Primary
Pharmacy 333600000X
Non-emergency Medical Transport (VAN) 343900000X

Addresses

Primary practice location

Road 111 KM 1.9
Los Patriotas Ave.
Lares, PR 00669-0379

Mailing address

PO Box 379
Lares, PR 00669-0379
Phone (787) 897-2727

Other practice location 1

1800 Ave Emerito Estrada
San Sebastian, PR 00685-3030
Phone (787) 897-2727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040603000147 PR Part B Supplier - Clinic/Group Practice 0840272985 Receives reassigned benefits from 32 practitioners
Practice locations: San Sebastian, PR; Lares, PR
O20141118000145 PR Part A Provider - Federally Qualified Health Center (FQHC) 0840272985 Practice locations: Lares, PR

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417907502. Details of each certification follow.

Federally qualified health center certification: CCN 401824

Legal name
CENTRO DE SALUD DE LARES INC
Doing business as
CENTROS INTEGRADOS DE SERVICIOS DE SALUD LARES QUEBRADILLAS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 18, 2014
Last certification
Nov 18, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 27, 1986 in PR
Enrollment address
111 Carr
Lares, PR 6690379

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lab CDT Quebradillas23 organizations share this tax ID, including this one
Part of
Lab CDT Quebradillas

Other organizations with this tax ID 22

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

View all 22

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Centro de Salud de Lares Inc Organization, Lares, PR Non-profit Operational/Managerial Control May 27, 1986
Damaris Rodriguez Individual Corporate Director Oct 5, 2022
W-2 Managing Employee Oct 5, 2022
Amilcar Rodriguez Individual Corporate DirectorPresident Board of Directors Mar 1, 2012
Maria Lugo Individual W-2 Managing EmployeeFinance Director Jan 11, 2011
Xiomara Rivera Individual Corporate DirectorDirector Board of Directors Jul 1, 2011
Luis a Oliver Individual Corporate DirectorVice President Board of Directors Mar 1, 2013
Carmen Rivera Individual Corporate DirectorSecretary Board of Directors May 1, 2008

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Centros Integrados de Servicios de Salud Lares QuebradillasQuebradillas, PR, CCN 401823 Federally qualified health center Operational/Managerial Control Apr 1, 1995

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777248000000",
    "number": "1417907502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 379",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690379",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROAD 111 KM 1.9",
            "address_2": "LOS PATRIOTAS AVE.",
            "city": "LARES",
            "state": "PR",
            "postal_code": "006690379",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Ave Emerito Estrada",
            "address_purpose": "LOCATION",
            "city": "San Sebastian",
            "state": "PR",
            "postal_code": "006853030",
            "country_code": "US",
            "telephone_number": "787-897-2727",
            "fax_number": "787-897-2725",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRO DE SALUD DE LARES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRO DE SALUD DE LARES, INC.",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "DAMARIS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "787-897-2727"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "PR",
            "license": "CNC99-285",
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lares, PR

Sources for this page

Verify at the official NPI Registry.