CDT SAN JUAN MEDICAL PLAZA – NPI #1134168354
Clinic/Center

CDT SAN JUAN MEDICAL PLAZA is an AHC clinic located in SAN JUAN, PR. NPPES has assigned the NPI number 1134168354 to CDT SAN JUAN MEDICAL PLAZA on June 05, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CDT SAN JUAN MEDICAL PLAZA” is a dba name, the actual legal business name for this organization is DE DIEGO AMBULATORY CLINIC CORP. The primary taxonomy selected by this provider is 261QE0002X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Emergency Care

The NPI profile was previously updated about 3 years ago on Mar 16, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CDT SAN JUAN MEDICAL PLAZA below.

NPI Profile for
DE DIEGO AMBULATORY CLINIC CORP

NPI Number
1134168354
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DE DIEGO AMBULATORY CLINIC CORP
Doing Business As (dba): CDT SAN JUAN MEDICAL PLAZA
Primary location
150 AVE DE DIEGO
CONDOMINIO SAN JUAN HEALTH CENTRE BOX 1
SAN JUAN, PR 00907-2300
Phone: (787) 977-7575 Fax: (787) 977-7605
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
PEDRO BEAUCHAMP
MEDICAL DIRECTOR
Phone: (787) 977-7575
Updated
Certification Date
Mar 16, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0002X
- Clinic/Center / Emergency Care (Primary)		 PR 105

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.