Individual provider Active NPI

Job Eliud Andujar, M.D.

  • Internal Medicine Physician
  • San Juan, PR
National Provider Identifier
1740208073
Registry record updated May 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9458 Issued in PR
Practice address
10 Calle Casia
San Juan, PR 00921-3200
Phone
(787) 641-3692
Fax
(787) 641-4566
NPI assigned
Jul 17, 2006
Last updated
May 26, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME65433 FL
Internal Medicine Physician 207R00000X 9458 PR Primary

Addresses

Primary practice location

10 Calle Casia
San Juan, PR 00921-3200

Mailing address

Carreta 195 Hacienda Margarita
Luquillo, PR 00773
Phone (787) 641-7582

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141016001799 PR Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5193946143

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME65433FLMDInternal Medicine Physician
9458PRMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243296000000",
    "number": "1740208073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CARRETA 195 HACIENDA MARGARITA",
            "city": "LUQUILLO",
            "state": "PR",
            "postal_code": "00773",
            "telephone_number": "787-641-7582",
            "fax_number": "787-641-4566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 CALLE CASIA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009213200",
            "telephone_number": "787-641-3692",
            "fax_number": "787-641-4566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDUJAR",
        "first_name": "JOB",
        "middle_name": "ELIUD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2009-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME65433",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "9458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.