Active NPI
Liselle Lathroum, M.D.
- Children's Hospital
- San Juan, PR
National Provider Identifier
1548512460
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Children's Hospital
- License
- 030165-R
- Practice address
- 230 Calle Viena
College Park
San Juan, PR 00921-4804 - Phone
- (787) 413-0779
- NPI assigned
- Oct 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Children's Hospital | 282NC2000X | 030165-R | PR | Primary |
Addresses
Primary practice location
230 Calle Viena
College Park
San Juan, PR 00921-4804
Mailing address
230 Calle Viena
College Park
San Juan, PR 00921-4804
Phone (787) 413-0779
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030165-R | PR | MD | Children's Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349222400000",
"number": "1548512460",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 CALLE VIENA",
"address_2": "COLLEGE PARK",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009214804",
"telephone_number": "787-413-0779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 CALLE VIENA",
"address_2": "COLLEGE PARK",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009214804",
"telephone_number": "787-413-0779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATHROUM",
"first_name": "LISELLE",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "282NC2000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Children",
"state": "PR",
"license": "030165-R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Juan, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.