SAN JORGE CHILDREN'S MEDICAL SPECIALTIES,PSC (NPI# 1043412752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043412752 |
| Entity Type | Organization |
| Organization Name | SAN JORGE CHILDREN'S MEDICAL SPECIALTIES,PSC |
| Other Organization Name | SAN JORGE CHILDREN'S MEDICAL SPECIALTIES AMB. SERVICES |
| Practice Address |
252 San Jorge Ave.san Jorge Medical Bldg San Jorge Medical Bldg Suite 504 Santurce PR 00912 |
| Mailing Address |
252 San Jorge Ave.san Jorge Medical Bldg San Jorge Medical Bldg Suite 504 Santurce PR 00912-3310 |
| Practice Telephone | 7877281575 |
| Mailing Telephone | 7877281575 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2010-02-10 |
| Authorized Official Name | DR. LUIS A. CLAVELL (DIRECTOR) |
| Authorized Official Telephone | 7877281575 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SAN JORGE CHILDRENS' MEDICAL SPECIALTIES, PSC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | 5762 | PR | Other Service Providers |
| Y | 261QX0200X |
Clinic/Center Specialization: Oncology |
05-B-1068 | PR | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PR | TRIPLE S | 12501 | 01 |
| PR | TRIPLE S | 20062 | 01 |
| Other Name | Type Code |
|---|---|
| San Jorge Children's Medical Specialties Amb. Services | Former Legal Business Name - Organization |
| Street Address |
252 SAN JORGE AVE.SAN JORGE MEDICAL BLDG SAN JORGE MEDICAL BLDG SUITE 504 |
| City | SANTURCE |
| State | PR |
| Zip Code | 00912 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860869 | Lismary Colon Matias | Speech-Language Pathologist | Avenida Ponce De Leon #1607, Cobian's Plaza Building, San Juan, PR 00912 | 2020-10-27 |
| 1972126258 | Neuropedeegpr LLC | Physiological Laboratory | Calle San Jorge #258 San Jorge Medical Building Suite 3, Santurce, PR 00912 | 2020-05-21 |
| 1801415047 | Racc | Surgery | #373 Calle San Jorge, Piso#2, Santurce, PR 00912 | 2020-04-08 |
| 1588299333 | Yanelis Perez Pina | Registered Nurse | 1600 Ave De La Constitucion, San Juan, PR 00912 | 2020-03-11 |
| 1558919233 | Aura Colon Rivera | Psychologist | Calle San Jorge, 258, San Juan, PR 00912 | 2019-08-27 |
| 1467923276 | Zuleika Montanez | Registered Nurse | 1600 Avenida Juan Ponce De Leon, San Juan, PR 00912 | 2018-12-06 |
| 1528584232 | Indhira M Rivas | Psychologist | 1551 Calle Victoria Santurce, San Juan, PR 00912 | 2017-08-15 |
| 1881146728 | Sebastian Cambo | Psychologist | 1801 Ave Ponce De Leon Suite 411, Santurce Medical Mall, San Juan, PR 00912 | 2016-10-26 |
| 1528430816 | Abner Martinez | Pharmacist | Calle Labra Esquina Corchado Parada 18, San Juan, PR 00912 | 2015-10-26 |
| 1609282300 | Mariola Llinas Messeguer | Obstetrics & Gynecology | 252 San Jorge Medical Building, Suite 405, Santurce, PR 00912 | 2014-07-02 |
| Find all providers in zip 00912 | ||||
| Taxonomy Code | 261QX0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Oncology |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment and prescriptive services related to cancerous conditions. Services include chemotherapy infusions and monitoring of implanted chemotherapeutic agents. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477753259 | Eileen Pacheco | Clinic/Center | Avenida De Diego359 Oficina 301, Santurce, PR 00909 | 2007-07-20 |
| 1104039734 | Oficina Dr. Alvaro Talavera | Clinic/Center | 1394 Calle San Rafael Ste #, Santurce, PR 00909-2541 | 2007-05-08 |
| 1043314388 | Adry Fernandez Lopez | Clinic/Center | 359 Ave De Diego, Suite301, Santurce, PR 00909-1739 | 2006-09-08 |
| 1407272610 | Rg Hematology Oncology Psc | Clinic/Center | 1427 Ave Fernandez Juncos, Oficina 201, Santurce, PR 00909-2658 | 2014-03-12 |
| 1306036272 | Dra Hilda Rivera Quinones | Clinic/Center | 29 Calle Washington, Ashford Medical Center Suite 604, Santurce, PR 00907-1510 | 2007-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447629100 | Nohse | Clinic/Center | 1-23 Ave Principal, Urb Baralt Suite 1, Fajardo, PR 00738 | 2015-09-23 |
| 1063804680 | Centro Oncologico De Cayey L.L.C. | Clinic/Center | Hc 73 Box 6440, Cayey, PR 00736-9529 | 2015-02-19 |
| 1174954481 | Centro Oncologico De La Mujer De Puerto Rico Csp | Clinic/Center | 1378 Calle Salud, Ponce, PR 00717-2004 | 2013-12-12 |
| 1548691579 | Recinto De Ciencias Medicas | Clinic/Center | Avenida Americo Miranda Centro Comercial, Reparto Metropolitano, Rio Piedras, PR 00929-0134 | 2013-12-02 |
| 1528492113 | Hematology & Oncology Medical Service PCs | Clinic/Center | Carr 14interior K 03 Barrio Rincon Sector Lomas, 308, Cayey, PR 00737-2800 | 2013-08-30 |
| 1821436312 | Servicios De Hematologia Y Oncologia Del Este, C.s.p. | Clinic/Center | Ave General Valero 410 Torre Medica San Pablo, Suite205, Fajardo, PR 00738 | 2013-06-06 |
| 1669815254 | Trust Medical and Oncology Center Psc | Clinic/Center | 4pn4 Via Josefina, Villa Fontana, Carolina, PR 00983-4828 | 2013-04-12 |
| 1578843652 | Centro Hematologico Y Oncologico Primavera P.s.c. | Clinic/Center | 172 Street Km 1.0, Centro De Salud Familiar Cidra, Cidra, PR 00739-3030 | 2011-08-22 |
| 1205122801 | Oncology Health Alliance Gr, P.s.c. | Clinic/Center | Carr. 14 Km 0.3, Hosp. Menonita Cayey - Ofic. Ctro Medico Nuclear, Cayey, PR 00736-0000 | 2011-06-22 |
| 1124323399 | Hematology Oncology Health Services, PC | Clinic/Center | 735 Ave Ponce De Leon Ste 701, San Juan, PR 00917-5029 | 2011-01-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.