Puerto Rico Performance Medical Group

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

219 Issued in PR

Legal business name

PUERTO RICO PERFORMANCE MEDICAL GROUP

Practice address

1 F12 Prado Alto
Guaynabo, PR 00966

Phone

(787) 460-1129

NPI assigned

Oct 22, 2013

Organization subpart

No

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

Authorized official

Name

Lucienne Laureano

Title

President

Phone

(787) 460-0538

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632873600000",
    "number": "1952739385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "F12 CALLE 1",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009663022",
            "telephone_number": "787-460-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 F12 PRADO ALTO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00966",
            "telephone_number": "787-460-1129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUERTO RICO PERFORMANCE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-22",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "LAUREANO",
        "authorized_official_first_name": "LUCIENNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-460-0538"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "PR",
            "license": "219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGE CARE ORGANIZATION",
            "identifier": "305500000X",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Puerto Rico Citylabs LLC
• Puerto Rico Counseling and Psychology Services
• Puerto Rico Hospital Internal Mecicine Services Coorp
• Puerto Rico Medical Services, LLC
• Puerto Rico Optical Company
• Puerto Rico Wound Care Centers LLC
• Livia A. Pulichino Lelong, PHD
• Pulmonary Alliance of PR,LLC
• Pure Health Services LLC
• Quality Dental Care & Esthetics, PSC

• Point of Service in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Point of Service in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.