Healthcare Provider Details

I. General information

NPI: 1780515767
Provider Name (Legal Business Name): CENTRO DE ENDOCRINOLOGIA INTEGRAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BAYAMON MEDICAL PLAZA SUITE 109
BAYAMON PR
00959-7203
US

IV. Provider business mailing address

PO BOX 151
BAYAMON PR
00960-0151
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-8030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State

VIII. Authorized Official

Name: HIRAM MALDONADO RIVERA
Title or Position: PROVIDER
Credential: MD
Phone: 787-467-5944