San Pablo Gastroenterology PSC

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

16988 Issued in PR

Legal business name

SAN PABLO GASTROENTEROLOGY PSC

Practice address

28 Santa Cruz Street
Torre San Pablo Suite 202-a
Bayamon, PR 00961

Phone

(787) 995-0500

Fax

(787) 785-0063

NPI assigned

Jun 16, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ricardo Juan Marrero, M.D.NPI 1093998320

Title

Owner

Phone

(787) 995-0500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 1

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

• Ricardo Juan Marrero, MD

  • Gastroenterology Physician
  • Miami Beach, FL
  • NPI 1093998320

  PR

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1487035390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 CARR 693",
            "address_2": "PMB 152",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006464816",
            "telephone_number": "787-995-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SANTA CRUZ STREET",
            "address_2": "TORRE SAN PABLO SUITE 202-A",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00961",
            "telephone_number": "787-995-0500",
            "fax_number": "787-785-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PABLO GASTROENTEROLOGY PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "MARRERO",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-995-0500",
        "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": "16988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zabdiel San Miguel Rosado Sr.
• San Pablo Developers Inc (Advanced Imaging Interventional Center)
• San Pablo Developers, Inc (Advanced Imaging Interventional Center)
• San Pablo Developers, Inc (Advanced Imaging Interventional Center)
• San Pablo Family Practice Inc
• San Pablo Medical
• San Pablo Pathology Group Inc.
• San Pablo Physical Medicine PSC
• San Pablo Surgical Associates
• Sana Accountable Care Organization of Puerto Rico Inc

• Gastroenterology Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Gastroenterology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.