Koby Hiram Bonilla Fernandez

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

24912 Issued in PR

Practice address

Urb. Alturas del Alba
C. Atardecer 10916
Villalba, PR 00766

Phone

(939) 451-9776

NPI assigned

Apr 10, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1962965616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10916 CALLE ATARDECER",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "007662339",
            "telephone_number": "939-451-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "URB. ALTURAS DEL ALBA",
            "address_2": "C. ATARDECER 10916",
            "city": "VILLALBA",
            "state": "PR",
            "postal_code": "00766",
            "telephone_number": "939-451-9776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Avenida Tito Castro",
            "address_2": "1255 Plaza las Monjitas, suite M 161",
            "address_purpose": "LOCATION",
            "city": "Ponce",
            "state": "PR",
            "postal_code": "00730",
            "country_code": "US",
            "telephone_number": "939-451-9776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONILLA FERNANDEZ",
        "first_name": "KOBY",
        "middle_name": "HIRAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-10",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PR",
            "license": "24912",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jesmarie Bonilla, MSW
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• Noralys Camacho
• Karilyn Cardona

• Obstetrics & Gynecology Physician in Villalba, PR
• Providers in Villalba, PR by specialty
• Obstetrics & Gynecology Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.