Sebastian Alexis Bonilla Benitez, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23372 Issued in PR

Practice address

404 Ave General Valero
Fajardo, PR 00738-3998

Phone

(787) 655-0505

NPI assigned

Aug 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Centro Medico del Turabo Inc

  dba Red Medica Hima San Pablo

  • Multi-Specialty Clinic/Center
  • Caguas, PR
  • NPI 1710107883

  General Practice

  Medicare reassignment NPD
• LS Trust Care Health Services LLC

  • General Practice Physician
  • Fajardo, PR
  • NPI 1235961004
  NPD Authorized official
• Centro Medico del Turabo Inc

  dba Nova Infusion

  • Home Infusion Therapy Pharmacy
  • Bayamon, PR
  • NPI 1811632581
  NPD
• LS Radiantlife Health Services LLC

  • General Practice Physician
  • Fajardo, PR
  • NPI 1235970286
  NPD

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1235803586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB VEVE CALZADA CALLE 3A O28",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "00738",
            "telephone_number": "787-602-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 AVE GENERAL VALERO",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383998",
            "telephone_number": "787-655-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 Ave Osvaldo Molina",
            "address_purpose": "LOCATION",
            "city": "Fajardo",
            "state": "PR",
            "postal_code": "007384013",
            "country_code": "US",
            "telephone_number": "787-801-0081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA BENITEZ",
        "first_name": "SEBASTIAN",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-02",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baralt Medical Equipment
• Livia M. Bermudez, M.D.
• Beta Gamma Nuclear Radiology, Inc.
• Beyond Med Care LLC
• Hildeberto Blasco, MD
• Borinquen Vision Corp.
• Judith Borrero-Walker, RD LND
• Kenneth Willard Brewster III, M.D.
• Manuel A Cabrera Diaz, M.D.
• John Axel Cabrera Ramos

• General Practice Physician in Fajardo, PR
• Providers in Fajardo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.