International Clinitian Medical Group PS

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15309 Issued in PR

Legal business name

INTERNATIONAL CLINITIAN MEDICAL GROUP PS

Practice address

Ave Hosto #54
San Juan, PR 00919

Phone

(787) 587-5410

NPI assigned

May 19, 2010

Organization subpart

No

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

Authorized official

Name

Pedro Carrazana

Title

President

Phone

(787) 587-5410

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1457670291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1198",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009601198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE HOSTO #54",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00919",
            "telephone_number": "787-587-5410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL CLINITIAN MEDICAL GROUP PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "CARRAZANA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-587-5410"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "15309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Behavioral Group LLC
• Inteligenciax LLC
• Intensive Care Transport Services, Inc.
• Inter American University of Puerto Rico
• Internal Medicine Professional Services, PSC
• International Health Care Consulting Inc.
• International Manage Care Service of Puerto Rico
• Intervencion Nutricional LLC
• Interventional Radiology Associates, P.S.C.
• Interventional Radiology Care Group

• Internal Medicine Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Internal Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.