Individual provider Active NPI

Eduardo J Maldonado-Colon

  • Physical Medicine & Rehabilitation Physician
  • San Juan, PR
National Provider Identifier
1932563723
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
021902 Issued in PR
Practice address
126 Ave de Diego, Ste 2
Sein Medical Plaza
San Juan, PR 00921-0001
Phone
(787) 208-2366
NPI assigned
Apr 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME151503 FL
Student in an Organized Health Care Education/Training Program 390200000X
Physical Medicine & Rehabilitation Physician 208100000X 021902 PR Primary

Addresses

Primary practice location

126 Ave de Diego, Ste 2
Sein Medical Plaza
San Juan, PR 00921-0001

Mailing address

81 Carretera 20, Apt 2
Villas de Tivoli
Guaynabo, PR 00966-0001
Phone (787) 438-9157

Other practice location 1

3702 Washington St Ste 303
Hollywood, FL 33021-8287
Phone (954) 518-2424

Other identifiers 1

IdentifierTypeStateIssuer
110837500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210917001944 FL Practitioner - Physical Medicine and Rehabilitation 6204233232 Reassigns benefits to 1 organization
I20230530003448 PR Practitioner - Physical Medicine and Rehabilitation 6204233232 Practice locations: San Juan, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Aug 1, 2021 Accepting new patients
South Broward Hospital District Physical Medicine & Rehabilitation CurrentSince Aug 1, 2021 Accepting new patients

Locations

3702 Washington St
Ste 303
Hollywood, FL 33021
Phone (954) 265-8326

2900 Corporate Way
#D
Miramar, FL 33025
Phone (954) 276-5581

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1932563723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 CARRETERA 20, APT 2",
            "address_2": "VILLAS DE TIVOLI",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009660001",
            "telephone_number": "787-438-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 AVE DE DIEGO, STE 2",
            "address_2": "SEIN MEDICAL PLAZA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009210001",
            "telephone_number": "787-208-2366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3702 Washington St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330218287",
            "country_code": "US",
            "telephone_number": "954-518-2424",
            "fax_number": "954-981-3476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO-COLON",
        "first_name": "EDUARDO",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-04-08",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME151503",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PR",
            "license": "021902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110837500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, PR

Sources for this page

Verify at the official NPI Registry.