Specialized Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

11593 Issued in PR

Legal business name

SPECIALIZED MEDICAL GROUP INC

Practice address

735 Ave Ponce de Leon
Suite 715
San Juan, PR 00917-5022

Phone

(787) 378-7748

Fax

(939) 336-5424

NPI assigned

Jul 9, 2015

Organization subpart

No

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

Authorized official

Name

Pedro F Del Valle, M.D.

Title

President

Phone

(787) 378-7748

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1436400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1962885871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON",
            "address_2": "SUITE 715",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175022",
            "telephone_number": "787-378-7748",
            "fax_number": "939-336-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 AVE PONCE DE LEON",
            "address_2": "SUITE 715",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009175022",
            "telephone_number": "787-378-7748",
            "fax_number": "939-336-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-09",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "DEL VALLE",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-378-7748",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "11593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Internal Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.