Organization Active NPI

Centro de Medicina Preventiva Cerv,CSP

  • General Practice Physician
  • Orocovis, PR
National Provider Identifier
1922414812
Registry record updated Jul 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
CENTRO DE MEDICINA PREVENTIVA CERV,CSP
Practice address
5 Calle Luis M Alfaro
Orocovis, PR 00720-4467
Phone
(787) 867-8085
Fax
(939) 212-7459
NPI assigned
Jul 11, 2014
Last updated
Jul 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2014

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

Authorized official

Name
Dr. Rodriguez Eulogio Carlos, M.D
Title
Medico
Phone
(787) 867-8085

Specialties & licenses 1

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

Addresses

Primary practice location

5 Calle Luis M Alfaro
Orocovis, PR 00720-4467

Mailing address

PO Box 157
Orocovis, PR 00720-0157
Phone (787) 868-8085

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141209001003 PR Part B Supplier - Clinic/Group Practice 2163744889 Receives reassigned benefits from 1 practitioner
Practice locations: Orocovis, PR

National Provider Directory

National Provider Directory

Locations

5 Calle Luis M Alfaro
Orocovis, PR 00720
Phone (787) 867-8085

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406505600000",
    "number": "1922414812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "007200157",
            "telephone_number": "787-868-8085",
            "fax_number": "939-212-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CALLE LUIS M ALFARO",
            "city": "OROCOVIS",
            "state": "PR",
            "postal_code": "007204467",
            "telephone_number": "787-867-8085",
            "fax_number": "939-212-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRO DE MEDICINA PREVENTIVA CERV,CSP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-28",
        "status": "A",
        "authorized_official_last_name": "CARLOS",
        "authorized_official_first_name": "RODRIGUEZ",
        "authorized_official_middle_name": "EULOGIO",
        "authorized_official_title_or_position": "MEDICO",
        "authorized_official_telephone_number": "787-867-8085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orocovis, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; 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.