Centro Otologico de Puerto Rico CSP

Primary specialty

Otology & Neurotology PhysicianTaxonomy code 207YX0901X

License

11064 Issued in PR

Legal business name

CENTRO OTOLOGICO DE PUERTO RICO CSP

Practice address

55 Calle de Diego E
Suite 105
Mayaguez, PR 00680-5078

Phone

(787) 833-2155

Fax

(787) 833-2680

NPI assigned

Nov 8, 2005

Last updated

Jul 12, 2011By 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

Miguel A Lasalle Lopez, MDNPI 1699810473

Title

Owner

Phone

(787) 833-2155

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Miguel A Lasalle Lopez, MD

  • Otology & Neurotology Physician
  • Mayaguez, PR
  • NPI 1699810473
  Medicare reassignment NPD Authorized official
• Quetsy Cruz Feliciano, A.U.D.

  • Audiologist
  • Mayaguez, PR
  • NPI 1093730483
  Medicare reassignment NPD
• Mariella Rodriguez Rodriguez

  • Audiologist
  • Ponce, PR
  • NPI 1184086027
  Medicare reassignment NPD
• Lulixa Martinez Perez, AUD

  • Audiologist
  • San German, PR
  • NPI 1932408630
  NPD (past)
• Jose Perez Fernandez, MD

  • General Practice Physician
  • Mayaguez, PR
  • NPI 1437286788
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1619958634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6428",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006816428",
            "telephone_number": "787-833-2155",
            "fax_number": "787-833-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CALLE DE DIEGO E",
            "address_2": "SUITE 105",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006805078",
            "telephone_number": "787-833-2155",
            "fax_number": "787-833-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO OTOLOGICO DE PUERTO RICO CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-08",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "LASALLE LOPEZ",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "787-833-2155",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "PR",
            "license": "11064",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PR",
            "license": "11064",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIPLES",
            "identifier": "20192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Centro Fisiatrico del Oeste CSP
• Centro Imagenes del Oeste
• Centro Neumologico del Oeste
• Centro Optometrico Dra Montesinos
• Centro Optometrico Dra Montesinos Inc
• Centro Quiropractico de Mayaguez, CSP
• Centro Radiologico del Oeste
• Centro Salud Mental Mayaguez
• Centro Tratamiento Ambulatorio Mayaguez
• Centro Urologico del Oeste

• Otology & Neurotology Physician in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Otology & Neurotology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.