Centro de Salud de Lares, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Lares, PR
NPI 1417907502 · NPPES record last updated Apr 27, 2026
Key facts
- NPI
- 1417907502
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- CNC99-285 (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
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTRO DE SALUD DE LARES, INC.
Authorized official
- Name
- Damaris Rodriguez
- Title
- Executive Director
- Phone
- (787) 897-2727
Owners & managing parties with NPI records 3
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 3
Corporate family (same tax ID) 22
Facilities with the same owner 1
Practitioners 56
-
Idamaris Alicea, M.D.
-
Frances C Baerga, M.D.
-
Frank H. Benitez, M. D.
-
Nicole De Pablo, MSW
-
Juan Matias, MD
-
Yariliz Ortiz, MD
-
Walter Rodriguez, M.D.
-
Waleska Gonzalez Nieves, M.D.
-
Adiannette Gonzalez, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PR
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
- Corporation · Non-profit
- Incorporated
- May 27, 1986 in PR
- Enrollment address
- 111 Carr
Lares, PR 6690379
All disclosed owners & managing parties 7
| Name | Role | Since | Share |
|---|---|---|---|
| Centro de Salud de Lares Inc |
Operational/Managerial Control | May 27, 1986 | |
| Damaris Rodriguez |
Corporate Director | Oct 5, 2022 | |
| W-2 Managing Employee | Oct 5, 2022 | ||
| Amilcar Rodriguez |
Corporate Director |
Mar 1, 2012 | |
| Maria Lugo |
W-2 Managing Employee |
Jan 11, 2011 | |
| Xiomara Rivera |
Corporate Director |
Jul 1, 2011 | |
| Luis a Oliver |
Corporate Director |
Mar 1, 2013 | |
| Carmen Rivera |
Corporate Director |
May 1, 2008 |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Centros Integrados de Servicios de Salud Lares Quebradillas |
Federally qualified health center | Operational/Managerial Control | Apr 1, 1995 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Centro de Salud de Lares Inc
- Part of
- Centro de Salud de Lares Inc
Locations
1800 Ave Emerito Estrada
San Sebastian, PR 00685
Phone (787) 896-5788
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | CNC99-285 | PR | Yes |
| 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
Other providers in Lares, PR
- Centro de Salud de Lares, Inc
- Centro de Salud de Lares, Inc
- Centro de Salud de Lares, Inc
- Centro de Salud de Lares, Inc
- Centro de Salud de Lares, Inc.
- Centro de Salud de Lares, Inc.
- Centro de Salud de Lares, Inc.
- Centro de Salud de Lares, Inc.
- Centro de Salud de Lares, Inc.
- Centro de Salud de Lares, Inc.
All providers in Lares, PR · Federally Qualified Health Center (FQHC) in Puerto Rico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.