Medical Walk in Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

12662 Issued in PR

Legal business name

MEDICAL WALK IN CLINIC LLC

Practice address

Avenida Campo Rico 923 Country Club
San Juan, PR 00924

Phone

(787) 755-3894

Fax

(787) 986-7525

NPI assigned

Mar 29, 2018

Last updated

Mar 29, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carlos Ruben Gonzalez, MD

Title

Physician/President

Phone

(787) 755-3894

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1568967651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29005 PMB 620",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009290005",
            "telephone_number": "787-755-3894",
            "fax_number": "787-986-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVENIDA CAMPO RICO 923 COUNTRY CLUB",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00924",
            "telephone_number": "787-755-3894",
            "fax_number": "787-986-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL WALK IN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "RUBEN",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "787-755-3894",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PR",
            "license": "12662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in San Juan, PR
• Providers in San Juan, PR by specialty
• Primary Care Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.