MEDICARE: CENTRO DE ENDOCRINOLOGIA INTEGRAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician

General Provider Information

NPI Number	:	1780515767
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRO DE ENDOCRINOLOGIA INTEGRAL LLC

Provider Business Mailing Address
First Line	:	PO BOX 151
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00960-0151
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	BAYAMON MEDICAL PLAZA SUITE 109
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00959-7203
Country	:	US
Telephone Number	:	787-783-8030
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER
Name	:	HIRAM MALDONADO RIVERA
Credential	:	MD
Telephone Number	:	787-467-5944

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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