NPIMap

Organization Active NPI

Personal Home Physician

  • Family Medicine Physician
  • Juncos, PR
National Provider Identifier
1487678736
Registry record updated Feb 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
15093 Issued in PR
Legal business name
PERSONAL HOME PHYSICIAN
Practice address
Carr. 31 Juncos Plaza
Local D-2
Juncos, PR 00777
Phone
(787) 713-6505
Fax
(787) 713-6505
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2012

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

Authorized official

Name
Mr. Ivan R. Rodriguez, M.D.
Title
President
Phone
(787) 713-6505

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 15093 PR Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 15093 PR

Addresses

Primary practice location

Carr. 31 Juncos Plaza
Local D-2
Juncos, PR 00777

Mailing address

PO Box 1221
Juncos, PR 00777-1221
Phone (787) 713-6505

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1487678736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007771221",
            "telephone_number": "787-713-6505",
            "fax_number": "787-713-6505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 31 JUNCOS PLAZA",
            "address_2": "LOCAL D-2",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "00777",
            "telephone_number": "787-713-6505",
            "fax_number": "787-713-6505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL HOME PHYSICIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "IVAN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-713-6505",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "15093",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "15093",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.