Active NPI
Southern Bariatric Services PSC
- Surgical Critical Care Physician
- Ponce, PR
National Provider Identifier
1750154787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Critical Care Physician
- Legal business name
- SOUTHERN BARIATRIC SERVICES PSC
- Practice address
- 909 Ave Tito Casto
Ste 723 Torre Medica San Lucas
Ponce, PR 00716-4725 - Phone
- (787) 290-4731
- NPI assigned
- Nov 1, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Guillermo Bonlanos, MD
- Title
- President
- Phone
- (787) 290-4731
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Critical Care Physician | 2086S0102X | Primary |
Addresses
Primary practice location
909 Ave Tito Casto
Ste 723 Torre Medica San Lucas
Ponce, PR 00716-4725
Mailing address
909 Ave Tito Casto
Ste 723 Torre Medica San Lucas
Ponce, PR 00716-4725
Phone (787) 290-4731
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231124000215 | PR | Part B Supplier - Clinic/Group Practice | 5496103889 |
Receives reassigned benefits from 1 practitioner Practice locations: Ponce, PR |
National Provider Directory
National Provider DirectoryLocations
909 Ave Tito Castro
Ste 72
Ponce, PR 00716
Phone (787) 290-4731
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Salinas, PR
- NPI 1942615927
-
- Surgery Physician
- Ponce, PR
- NPI 1487031431
-
- Surgery Physician
- Ponce, PR
- NPI 1851656672
-
- Nephrology Physician
- Ponce, PR
- NPI 1497876916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698796800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698796800000",
"number": "1750154787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "909 AVE TITO CASTO",
"address_2": "STE 723 TORRE MEDICA SAN LUCAS",
"city": "PONCE",
"state": "PR",
"postal_code": "007164725",
"telephone_number": "787-290-4731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 AVE TITO CASTO",
"address_2": "STE 723 TORRE MEDICA SAN LUCAS",
"city": "PONCE",
"state": "PR",
"postal_code": "007164725",
"telephone_number": "787-290-4731"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHERN BARIATRIC SERVICES PSC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-01",
"last_updated": "2023-11-01",
"certification_date": "2023-10-31",
"status": "A",
"authorized_official_last_name": "BONLANOS",
"authorized_official_first_name": "GUILLERMO",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "787-290-4731",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Surgical Critical Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponce, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.