Healthcare Provider Details

I. General information

NPI: 1841124260
Provider Name (Legal Business Name): PUERTO RICO INSTITUTE FOR KIDNEY AND ENDOCRINE DISORDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HC 3 BOX 5503
ADJUNTAS PR
00601-9378
US

IV. Provider business mailing address

HC 3 BOX 5503
ADJUNTAS PR
00601-9378
US

V. Phone/Fax

Practice location:
  • Phone: 939-388-1116
  • Fax:
Mailing address:
  • Phone: 939-388-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LUIS NORBERTO MADERA
Title or Position: OWNER/PRESIDENT
Credential: MD
Phone: 939-388-1116