NPIMap

Organization Active NPI

Centro Gastro-Endoscopico de la Montana Corp

  • Gastroenterology Physician
  • Corozal, PR
National Provider Identifier
1447799358
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
8686 Issued in PR
Legal business name
CENTRO GASTRO-ENDOSCOPICO DE LA MONTANA CORP
Practice address
Carr 159 # KM27.4
Corozal Shopping Village
Corozal, PR 00783-2903
Phone
(787) 802-1400
Fax
(787) 802-1200
NPI assigned
Feb 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Authorized official

Name
Dr. Eladio Perez Cruz, M.D.NPI 1194701706
Title
President
Phone
(787) 802-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 8686 PR Primary

Addresses

Primary practice location

Carr 159 # KM27.4
Corozal Shopping Village
Corozal, PR 00783-2903

Mailing address

PO Box 19006
San Juan, PR 00910
Phone (787) 802-1400

Other identifiers 1

IdentifierTypeStateIssuer
390127OtherPRCERTIFICATE OF REGISTRY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1447799358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19006",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00910",
            "telephone_number": "787-802-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 159 # KM27.4",
            "address_2": "COROZAL SHOPPING VILLAGE",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007832903",
            "telephone_number": "787-802-1400",
            "fax_number": "787-802-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO GASTRO-ENDOSCOPICO DE LA MONTANA CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "PEREZ CRUZ",
        "authorized_official_first_name": "ELADIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-802-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "PR",
            "license": "8686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFICATE OF REGISTRY",
            "identifier": "390127",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corozal, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.