Dr Nelson R Medina, MD C.S.P.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12324 Issued in PR

Legal business name

DR NELSON R MEDINA, MD C.S.P.

Practice address

Edificio Porrata Pila 2431 Ave. Las Americas
Suite 101
Ponce, PR 00731

Phone

(787) 813-2385

Fax

(787) 984-1691

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nelson R Medina Moreno, M.D.

Title

Medico

Phone

(787) 813-2385

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Nelson R Medina, M.D.

  • Gastroenterology Physician
  • Coto Laurel, PR
  • NPI 1770543514
  NPD (past)

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467588186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332228",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007332228",
            "telephone_number": "787-813-2385",
            "fax_number": "787-984-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EDIFICIO PORRATA PILA 2431 AVE. LAS AMERICAS",
            "address_2": "SUITE 101",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "00731",
            "telephone_number": "787-813-2385",
            "fax_number": "787-984-1691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR NELSON R MEDINA, MD C.S.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEDINA MORENO",
        "authorized_official_first_name": "NELSON",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICO",
        "authorized_official_telephone_number": "787-813-2385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "12324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770543514",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Ponce, PR
• Providers in Ponce, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.