Mayaguez Sport Medicine L L C

Primary specialty

SpecialistTaxonomy code 174400000X

License

17246 Issued in PR

Legal business name

MAYAGUEZ SPORT MEDICINE L L C

Practice address

875 Ave Hostos
Mayaguez, PR 00680-1529

Phone

(787) 652-3800

Fax

(787) 652-3802

NPI assigned

Mar 19, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Carlos J Perez Lopez, M.D.

Title

President

Phone

(787) 464-2788

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1699192336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006810418",
            "telephone_number": "787-652-3800",
            "fax_number": "787-652-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 AVE HOSTOS",
            "city": "MAYAGUEZ",
            "state": "PR",
            "postal_code": "006801529",
            "telephone_number": "787-652-3800",
            "fax_number": "787-652-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYAGUEZ SPORT MEDICINE L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ LOPEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-464-2788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "17246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Med Help

• Specialist in Mayaguez, PR
• Providers in Mayaguez, PR by specialty
• Specialist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.