Prevntive Medical Alliance Inc

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

14432 Issued in PR

Legal business name

PREVNTIVE MEDICAL ALLIANCE INC

Practice address

Ave Los Rotarios Carr 4415 KM 1.5
Suite 2
Aguada, PR 00602

Phone

(787) 975-2555

NPI assigned

Jul 10, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Hiram Josue Ortega, MD

Title

President

Phone

(787) 431-6710

Specialties & licenses 1

Addresses

Other names 1

• Preventive Medical Alliance INC Former legal business name

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1922594282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "006020122",
            "telephone_number": "787-975-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AVE LOS ROTARIOS CARR 4415 KM 1.5",
            "address_2": "SUITE 2",
            "city": "AGUADA",
            "state": "PR",
            "postal_code": "00602",
            "telephone_number": "787-975-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVNTIVE MEDICAL ALLIANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "HIRAM",
        "authorized_official_middle_name": "JOSUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-431-6710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "PR",
            "license": "14432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Preventive Medical Alliance INC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Preventive Medical Alliance INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Case Manager/Care Coordinator in Aguada, PR
• Providers in Aguada, PR by specialty
• Case Manager/Care Coordinator in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.