Bayamon Pediatric and Adolescent Medicine Services,PSC

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

6155 Issued in PR

Legal business name

BAYAMON PEDIATRIC AND ADOLESCENT MEDICINE SERVICES,PSC

Practice address

Bayamon Medical PLZ
Suite 304
Bayamon, PR 00959-7200

Phone

(787) 786-1873

Fax

(787) 622-0024

NPI assigned

Jan 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Luis F Olmedo, MD

Title

President

Phone

(787) 786-1873

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1137801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508846759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009702078",
            "telephone_number": "787-786-1873",
            "fax_number": "787-622-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BAYAMON MEDICAL PLZ",
            "address_2": "SUITE 304",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009597200",
            "telephone_number": "787-786-1873",
            "fax_number": "787-622-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYAMON PEDIATRIC AND ADOLESCENT MEDICINE SERVICES,PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLMEDO",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-786-1873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "PR",
            "license": "6155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bayamon Medical Wellness Center, PSC
• Bayamon Neurology Services, PSC
• Bayamon Oncology Medical CSP
• Bayamon Optical Inc
• Bayamon Parcial
• Bayamon Pediatric Pulmonary Services
• Bayamon Podiatric Clinic PSC
• Bayamon Prosthetics & Orthotics Inc
• Bayamon Radiology LLC
• Maribel Bayona Sastre, M.ED M.PSY.D

• Pediatric Adolescent Medicine Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• Pediatric Adolescent Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.