Centro Medico Central Coto Laurel, Inc

Key facts

NPI

1679529648

Entity type

Organization (NPI type 2)

Primary specialty

Specialist 174400000X

License

12464 (PR)

Legal business name

CENTRO MEDICO CENTRAL COTO LAUREL, INC

Practice address

103 Calle Central
Coto Laurel, PR 00780-2145

Phone

(787) 842-7856

Fax

(787) 842-7836

NPI assigned

May 25, 2006

Organization subpart

No

Authorized official

Name

Mrs. Ana L Santos

Title

Administrator

Phone

(787) 842-7856

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

• Centro Vacunacion Primary Care Clinic/Center · Coto Laurel, PR · NPI 1356646491
  NPD tax ID

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erika Gomez, M.D. General Practice Physician · Ponce, PR · NPI 1497989818
  Medicare reassignment NPD PR
• Idel A Vazquez, M.D. General Practice Physician · San Juan, PR · NPI 1699868315
  Medicare reassignment NPD PR
• Yiselle Lopez Ortiz, M.D. General Practice Physician · Juana Diaz, PR · NPI 1902918162
  NPD (past)
• Zacarias A Mateo Minaya, MD Specialist · Santa Isabel, PR · NPI 1700990744
  NPD (past) SPECIALIST
• Jomarie Rivera Irizarry, MD General Practice Physician · Luquillo, PR · NPI 1922092758
  NPD (past)
• Glenda Milagros Rodriguez, MD General Practice Physician · Juana Diaz, PR · NPI 1194768150
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in PR

Medicare enrollment records

National Provider Directory

Tax ID family

Centro Medico Central Coto Laurel (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 24, 2013.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1679529648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CALLE CENTRAL",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802103",
            "telephone_number": "787-842-7856",
            "fax_number": "787-842-7836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CALLE CENTRAL",
            "city": "COTO LAUREL",
            "state": "PR",
            "postal_code": "007802145",
            "telephone_number": "787-842-7856",
            "fax_number": "787-842-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO MEDICO CENTRAL COTO LAUREL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "787-842-7856",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "12464",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "2615",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "14978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coto Laurel, PR

• Carive OB GYN
• Jose J. Castillo, D.M.D.
• Marielys Castro Arroyo, MD
• Centro Integrado de Cancer del Sur, PSC
• Centro Integrado de Cancer del Sur, PSC
• Centro Suenos Y Palabras LLC
• Centro Vacunacion
• Maria C Cestero Lopez, MD
• Clinica de Fisiatria Neuromuscular de Ponce, C.S.P.
• Clinica Familiar Coto Laurel Inc

All providers in Coto Laurel, PR · Specialist in Puerto Rico