Instituto de Neurologia Dra. Ivonne Fraga, PSC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

13162 Issued in PR

Legal business name

INSTITUTO DE NEUROLOGIA DRA. IVONNE FRAGA, PSC

Practice address

708 Ave Ponce de Leon
Suite 102
San Juan, PR 00918-4502

Phone

(787) 763-9312

Fax

(787) 294-1246

NPI assigned

Mar 10, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Ivonne De Lourdes Fraga, M.D.

Title

President

Phone

(787) 403-5534

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Ivonne de L Fraga Berrios, MD

  • Neurology Physician
  • San Juan, PR
  • NPI 1033116264
  NPD (past)
• Martin H Lugo Fagundo, MD

  • Internal Medicine Physician
  • San Juan, PR
  • NPI 1316944549
  NPD (past)

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

{
    "created_epoch": "1425945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425945600000",
    "number": "1689067027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7891",
            "address_2": "PMB 191",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009707891",
            "telephone_number": "787-403-5534",
            "fax_number": "787-294-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 AVE PONCE DE LEON",
            "address_2": "SUITE 102",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009184502",
            "telephone_number": "787-763-9312",
            "fax_number": "787-294-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTO DE NEUROLOGIA DRA. IVONNE FRAGA, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-10",
        "last_updated": "2015-03-10",
        "status": "A",
        "authorized_official_last_name": "FRAGA",
        "authorized_official_first_name": "IVONNE",
        "authorized_official_middle_name": "DE LOURDES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-403-5534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "PR",
            "license": "13162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in San Juan, PR
• Providers in San Juan, PR by specialty
• Medical Specialty Clinic/Center in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.