Medicina Primaria Buena Vista LLC.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MEDICINA PRIMARIA BUENA VISTA LLC.

Practice address

Carr. 167 KM 15.1
Barrio Buena Vista
Bayamon, PR 00956

Phone

(787) 797-0754

NPI assigned

Mar 22, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Eva Liz Colon Maldonado, M.D.NPI 1245302603

Title

Presidenta

Phone

(787) 903-1254

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Practitioners 1

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

• Eva Liz Colon Maldonado, MD

  • General Practice Physician
  • Bayamon, PR
  • NPI 1245302603
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1306549209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3269 CALLE MONTE LA MINA",
            "address_2": "URB. PRDERAS DEL RIO",
            "city": "TOA ALTA",
            "state": "PR",
            "postal_code": "009539132",
            "telephone_number": "787-797-0754",
            "fax_number": "787-797-0754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR. 167 KM 15.1",
            "address_2": "BARRIO BUENA VISTA",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "00956",
            "telephone_number": "787-797-0754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINA PRIMARIA BUENA VISTA LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "COLON MALDONADO",
        "authorized_official_first_name": "EVA",
        "authorized_official_middle_name": "LIZ",
        "authorized_official_title_or_position": "PRESIDENTA",
        "authorized_official_telephone_number": "787-903-1254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.