Individual provider Active NPI

Lerac Otero, MD

  • Specialist
  • Guaynabo, PR
National Provider Identifier
1962612648
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
9348 Issued in PR
Practice address
Calle San Miguel
Apartamento 65
Guaynabo, PR 00966-7941
Phone
(787) 647-3667
Fax
(787) 782-0870
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 9348 PR Primary

Addresses

Primary practice location

Calle San Miguel
Apartamento 65
Guaynabo, PR 00966-7941

Mailing address

Calle San Miguel
Apartamento 65
Guaynabo, PR 00966-7941
Phone (787) 647-3667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9348PRMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962612648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CALLE SAN MIGUEL",
            "address_2": "APARTAMENTO 65",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009667941",
            "telephone_number": "787-647-3667",
            "fax_number": "787-782-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE SAN MIGUEL",
            "address_2": "APARTAMENTO 65",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009667941",
            "telephone_number": "787-647-3667",
            "fax_number": "787-782-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTERO",
        "first_name": "LERAC",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PR",
            "license": "9348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guaynabo, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.