Organization Active NPI

Guaynabo Endocrinology Center P.S.C.

  • Endocrinology, Diabetes & Metabolism Physician
  • Guaynabo, PR
National Provider Identifier
1205461092
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
GUAYNABO ENDOCRINOLOGY CENTER P.S.C.
Practice address
136 Calle Carazo
Guaynabo, PR 00969-6412
Phone
(787) 708-6200
Fax
(787) 708-6228
NPI assigned
Mar 11, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Enrique Raul Maldonado Corchado, MDNPI 1972873792
Title
MD
Phone
(787) 708-6200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

136 Calle Carazo
Guaynabo, PR 00969-6412

Mailing address

PO Box 3972
Guaynabo, PR 00970-3972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200706001069 PR Part B Supplier - Clinic/Group Practice 4486077716 Receives reassigned benefits from 1 practitioner
Practice locations: Guaynabo, PR

National Provider Directory

National Provider Directory

Locations

136 Calle Carazo
Ste 3
Guaynabo, PR 00969
Phone (787) 414-9722

136 Calle Carazo
Guaynabo, PR 00969
Phone (787) 708-6200

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1583884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1205461092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3972",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009703972",
            "fax_number": "787-708-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 CALLE CARAZO",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009696412",
            "telephone_number": "787-708-6200",
            "fax_number": "787-708-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUAYNABO ENDOCRINOLOGY CENTER P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-11",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "MALDONADO CORCHADO",
        "authorized_official_first_name": "ENRIQUE",
        "authorized_official_middle_name": "RAUL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "787-708-6200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "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 Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.