Organization Active NPI

Michelen Dermatology LLC

Doing business as Michelen Dermatology

  • Dermatology Physician
  • San Juan, PR
National Provider Identifier
1952281032
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MICHELEN DERMATOLOGY LLC
Doing business as
Michelen Dermatology
Practice address
Urb. Sagrado Corazon, Calle Santa Angela #1632
San Juan, PR 00926
Phone
(787) 508-6563
NPI assigned
Sep 8, 2025
Last updated
Sep 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Authorized official

Name
Eduardo Michelen GomezNPI 1467916726
Title
Lawyer
Phone
(787) 508-6563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

Urb. Sagrado Corazon, Calle Santa Angela #1632
San Juan, PR 00926

Mailing address

Urb. Sagrado Corazon, Calle Santa Angela #1632
San Juan, PR 00926

Other practice location 1

Calle Orquidea A-48 Urb. Loiza Valley
Canovanas, PR 00729
Phone (787) 508-6563

Other names 1

  • MICHELEN DERMATOLOGY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251216004893 PR Part B Supplier - Clinic/Group Practice 3274028311 Receives reassigned benefits from 1 practitioner
Practice locations: Canovanas, PR

National Provider Directory

National Provider Directory

Locations

48 Calle Orquidea
Canovanas, PR 00729
Phone (787) 256-0848

Practitioners & affiliated clinicians

Practitioners 3

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": "1757289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757289600000",
    "number": "1952281032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. SAGRADO CORAZON, CALLE SANTA ANGELA #1632",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. SAGRADO CORAZON, CALLE SANTA ANGELA #1632",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00926",
            "telephone_number": "787-508-6563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Calle Orquidea A-48 Urb. Loiza Valley",
            "address_purpose": "LOCATION",
            "city": "CANOVANAS",
            "state": "PR",
            "postal_code": "00729",
            "country_code": "US",
            "telephone_number": "787-508-6563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MICHELEN DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "MICHELEN GOMEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "LAWYER",
        "authorized_official_telephone_number": "787-508-6563"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MICHELEN DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Juan, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.