Idamar Laureano Landron, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

11704 Issued in PR

Practice address

Lote 1Metro Office Park
Suite 400
Guaynabo, PR 00968

Phone

(787) 774-3344

Fax

(787) 774-6251

NPI assigned

Mar 30, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740300839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 STREET SANTA JUANITA",
            "address_2": "PMB 334 UU1",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-396-7423",
            "fax_number": "787-288-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LOTE 1METRO OFFICE PARK",
            "address_2": "SUITE 400",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-774-3344",
            "fax_number": "787-774-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUREANO LANDRON",
        "first_name": "IDAMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "11704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCIA DE CHOFER",
            "identifier": "1625033",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "11704",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Family Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.