NPIMap

Organization Active NPI

Nefrologia Intervencional CSP

  • Nephrology Physician
  • Mayaguez, PR
National Provider Identifier
1649225806
Registry record updated May 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
12534 Issued in PR
Legal business name
NEFROLOGIA INTERVENCIONAL CSP
Practice address
351 Ave Hostos
Medical Emporium Suite 208
Mayaguez, PR 00680-1502
Phone
(787) 805-7640
Fax
(787) 805-7620
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2008

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

Authorized official

Name
Dr. Justo Luis Gonzalez, M.D.
Title
President
Phone
(787) 805-7640

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X 12534 PR Primary

Addresses

Primary practice location

351 Ave Hostos
Medical Emporium Suite 208
Mayaguez, PR 00680-1502

Mailing address

PO Box 3007
Mayaguez, PR 00681-3007
Phone (787) 805-7640

National Provider Directory

National Provider Directory

Locations

351 Ave Hostos
Ste 208
Mayaguez, PR 00680
Phone (787) 805-7640

Practitioners & affiliated clinicians

Practitioners 1

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1649225806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006813007",
            "telephone_number": "787-805-7640",
            "fax_number": "787-805-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 AVE HOSTOS",
            "address_2": "MEDICAL EMPORIUM SUITE 208",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801502",
            "telephone_number": "787-805-7640",
            "fax_number": "787-805-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEFROLOGIA INTERVENCIONAL CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "JUSTO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-805-7640",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "PR",
            "license": "12534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayaguez, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.