Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
LA VIDA MEDICAL GROUP HATILLO CORP
Active
Organization
LA VIDA MEDICAL GROUP HATILLO CORP
Active
Other names
LOS ANGELES MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANA I MATOS (BILLING MANAGER)
(787) 880-2363
Entity
Organization
Contact information
Practice address
549 CALLE DEL MAR, SUITE 302, HATILLO, PR 00659-2869
(787) 880-2363
(787) 881-4312
Mailing address
549 CALLE DEL MAR, SUITE 302, HATILLO, PR 00659-2869
(787) 880-2363
(787) 881-4312
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
13836
PR
213E00000X
Podiatrist
000085
PR
261QR0206X
Mammography Clinic/Center
—
—
Other
Enumeration date
06/27/2007
Last updated
05/16/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up