NPIMap

Organization Active NPI

Ipa Policlinica Villa Los Santos

  • General Practice Physician
  • Arecibo, PR
National Provider Identifier
1457562084
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
IPA POLICLINICA VILLA LOS SANTOS
Practice address
Urb. Villa Los Santos
Calle 16 V-1
Arecibo, PR 00612
Phone
(787) 879-1585
Fax
(787) 879-4315
NPI assigned
May 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Authorized official

Name
Dr. Maria Gonzalez Agraso, M.D
Title
Administrator
Phone
(787) 817-3144

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

Urb. Villa Los Santos
Calle 16 V-1
Arecibo, PR 00612

Mailing address

PO Box 9091
Cotto Station
Arecibo, PR 00613-9091
Phone (787) 879-1585

Other identifiers 1

IdentifierTypeStateIssuer
17064OtherPRPROVIDER #

Other names 1

  • HORARIO EXTENDIDO IPA 029 Other name

National Provider Directory

National Provider Directory
Tax ID family
Centro Vacunacion Ipa294 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1180051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1457562084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9091",
            "address_2": "COTTO STATION",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "006139091",
            "telephone_number": "787-879-1585",
            "fax_number": "787-879-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. VILLA LOS SANTOS",
            "address_2": "CALLE 16 V-1",
            "city": "ARECIBO",
            "state": "PR",
            "postal_code": "00612",
            "telephone_number": "787-879-1585",
            "fax_number": "787-879-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPA POLICLINICA VILLA LOS SANTOS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-25",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "AGRASO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "GONZALEZ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-817-3144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #",
            "identifier": "17064",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HORARIO EXTENDIDO IPA 029",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arecibo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.