Individual provider Active NPI

Roberto Santiago Bonilla

  • Clinical Social Worker
  • Santa Isabel, PR
National Provider Identifier
1780424226
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16033 Issued in PR
Practice address
HC 2 Box 3476
Santa Isabel, PR 00757-9704
Phone
(939) 222-9316
NPI assigned
May 31, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16033 PR Primary

Addresses

Primary practice location

HC 2 Box 3476
Santa Isabel, PR 00757-9704

Mailing address

HC 2 Box 3476
Santa Isabel, PR 00757-9704
Phone (939) 222-9316

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16033PRMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1780424226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 3476",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007579704",
            "telephone_number": "939-222-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HC 2 BOX 3476",
            "city": "SANTA ISABEL",
            "state": "PR",
            "postal_code": "007579704",
            "telephone_number": "939-222-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO BONILLA",
        "first_name": "ROBERTO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PR",
            "license": "16033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Isabel, PR

Sources for this page

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