Imcs Holdings of PR

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

IMCS HOLDINGS OF PR

Practice address

1870-A San Antonio Street
Pda 26
San Juan, PR 00909

Phone

(787) 726-9620

Fax

(787) 726-1720

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Nelida Gomez, PHDC, CPUM, CPUR

Title

President

Phone

(787) 726-9620

Specialties & licenses 1

Addresses

Other names 1

• IMCS HOLDINGS Former legal business name

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811078926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870-A SAN ANTONIO STREET",
            "address_2": "PDA 26",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00909",
            "telephone_number": "787-726-9620",
            "fax_number": "787-726-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870-A SAN ANTONIO STREET",
            "address_2": "PDA 26",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00909",
            "telephone_number": "787-726-9620",
            "fax_number": "787-726-1720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMCS HOLDINGS OF PR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "NELIDA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-726-9620",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHDC, CPUM, CPUR"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "PR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMCS HOLDINGS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Preferred Provider Organization in San Juan, PR
• Providers in San Juan, PR by specialty
• Preferred Provider Organization in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.