Centro de Medicina Interna Avanza San Claudio

Primary specialty

SpecialistTaxonomy code 174400000X

License

14822 Issued in PR

Legal business name

CENTRO DE MEDICINA INTERNA AVANZA SAN CLAUDIO

Practice address

396 Ave San Claudio
San Juan, PR 00926-4107

Phone

(787) 748-9955

Fax

(787) 946-8712

NPI assigned

Mar 13, 2009

Last updated

Mar 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Miguel Juan Boque, M.D.

Title

President

Phone

(787) 748-9955

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236902400000",
    "number": "1720229123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 361062",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009361062",
            "telephone_number": "787-748-9955",
            "fax_number": "787-946-8712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 AVE SAN CLAUDIO",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009264107",
            "telephone_number": "787-748-9955",
            "fax_number": "787-946-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE MEDICINA INTERNA AVANZA SAN CLAUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-13",
        "last_updated": "2009-03-13",
        "status": "A",
        "authorized_official_last_name": "BOQUE",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "JUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-748-9955",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "PR",
            "license": "14822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Juan, PR
• Providers in San Juan, 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 13, 2009; 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.