Fajardo Medical LLC

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

Legal business name

FAJARDO MEDICAL LLC

Practice address

57 Calle Isabel Andreu E
Fajardo, PR 00738-4806

Phone

(787) 663-6770

NPI assigned

Oct 17, 2022

Last updated

Jan 31, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carly Carrion Olmeda, MDNPI 1154671444

Title

Physician

Phone

(330) 979-7218

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carly Carrion Olmeda, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Ocala, FL
  • NPI 1154671444

  PR

  Medicare reassignment Care Compare group NPD Authorized official
• Ana Lucia Sanchez Ferreras, MD

  • Obesity Medicine (Internal Medicine) Physician
  • Fajardo, PR
  • NPI 1407133325
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1457077984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5A18 CALLE 5-2",
            "address_2": "URB. JARDINES DE MONTE BRISAS",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007383115",
            "telephone_number": "330-979-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 CALLE ISABEL ANDREU E",
            "city": "FAJARDO",
            "state": "PR",
            "postal_code": "007384806",
            "telephone_number": "787-663-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAJARDO MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-17",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "CARRION OLMEDA",
        "authorized_official_first_name": "CARLY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "330-979-7218",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fajardo Imaging Inc
• Fajardo Integrated Medical Center
• Fajardo Medical Practice
• Fajardo Medical Practice
• Fajardo Seniors Castle LLC
• Farmacia del Este (Farmacia Triunfo)
• Farmacia Emanuelli,Inc

• Endocrinology, Diabetes & Metabolism Physician in Fajardo, PR
• Providers in Fajardo, PR by specialty
• Endocrinology, Diabetes & Metabolism Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.