Waterfall Health Service Management, Corp

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WATERFALL HEALTH SERVICE MANAGEMENT, CORP

Practice address

77 Chile Street
Urb Floral Park
San Juan, PR 00922

Phone

(787) 249-1521

NPI assigned

Oct 18, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Gloria Diaz, MHSA

Title

Vice-President

Phone

(787) 249-1521

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1578873055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10376",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00922",
            "telephone_number": "787-249-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CHILE STREET",
            "address_2": "URB FLORAL PARK",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00922",
            "telephone_number": "787-249-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFALL HEALTH SERVICE MANAGEMENT, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "787-249-1521",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHSA"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.