Individual provider Active NPI

Enrique F Solivan Sobrino, M.D.

  • General Practice Physician
  • Juncos, PR
National Provider Identifier
1992960355
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
17245 Issued in PR
Practice address
Calle Victor Torres 5 Local 1
Valencia II
Juncos, PR 00777-3817
Phone
(787) 204-8547
NPI assigned
Jul 25, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 17245 PR Primary

Addresses

Primary practice location

Calle Victor Torres 5 Local 1
Valencia II
Juncos, PR 00777-3817

Mailing address

PO Box 7106
Caguas, PR 00726-7106
Phone (787) 204-8547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121212000360 PR Practitioner - General Practice 3971755216 Reassigns benefits to 1 organization
Practice locations: Juncos, PR

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5 Calle Victor Torres
Juncos, PR 00777-3817
Phone (787) 204-8547

Hospital & facility affiliations

  • Ryder Homecare Program Home health agency, Humacao, PR, CCN 407005
  • Ryder Memorial Hospital Inc Hospital, Humacao, PR, CCN 400007
  • Ryder Memorial Hospital Inc Nursing home, Humacao, PR, CCN 405018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17245PRMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Centro Medico del Turabo Inc General Practice CurrentSince Nov 30, 2019 Accepting new patients
Centro Medico del Turabo Inc CurrentSince Nov 30, 2019 Accepting new patients
Ryder Memorial Hospital Inc Past Accepting new patients

Locations

100 Ave Luis Munoz Marin
Caguas, PR 00725
Phone (787) 423-2261

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1992960355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7106",
            "city": "CAGUAS",
            "state": "PR",
            "postal_code": "007267106",
            "telephone_number": "787-204-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE VICTOR TORRES 5 LOCAL 1",
            "address_2": "VALENCIA II",
            "city": "JUNCOS",
            "state": "PR",
            "postal_code": "007773817",
            "telephone_number": "787-204-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIVAN SOBRINO",
        "first_name": "ENRIQUE",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-25",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juncos, PR

Sources for this page

Verify at the official NPI Registry.