Organization Active NPI

Clinica Mundo Salud San Sebastian C.S.P.

  • General Practice Physician
  • San Sebastian, PR
National Provider Identifier
1700107513
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17408 Issued in PR
Legal business name
CLINICA MUNDO SALUD SAN SEBASTIAN C.S.P.
Practice address
594 Ave Emerito Estrada Rivera
San Sebastian, PR 00685-3114
Phone
(787) 280-2626
NPI assigned
Jun 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Authorized official

Name
Hector Juan Perez Feliciano, M.DNPI 1801031257
Title
President
Phone
(787) 280-2626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 17408 PR Primary

Addresses

Primary practice location

594 Ave Emerito Estrada Rivera
San Sebastian, PR 00685-3114

Mailing address

PO Box 397
San Sebastian, PR 00685-0397
Phone (787) 280-2626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121115000135 PR Part B Supplier - Clinic/Group Practice 1759532088 Receives reassigned benefits from 1 practitioner
Practice locations: Las Marias, PR; San Sebastian, PR

National Provider Directory

National Provider Directory

Locations

594 Ave Emerito Estrada
San Sebastian, PR 00685
Phone (787) 280-2626

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": "1276560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276560000000",
    "number": "1700107513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 397",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006850397",
            "telephone_number": "787-280-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 AVE EMERITO ESTRADA RIVERA",
            "city": "SAN SEBASTIAN",
            "state": "PR",
            "postal_code": "006853114",
            "telephone_number": "787-280-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA MUNDO SALUD SAN SEBASTIAN C.S.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-15",
        "last_updated": "2010-06-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ FELICIANO",
        "authorized_official_first_name": "HECTOR",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-280-2626",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "PR",
            "license": "17408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Sebastian, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2010; 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.