Healthcare Provider Details

I. General information

NPI: 1659060119
Provider Name (Legal Business Name): ESTEFANY PENA HILARIO MD, RDMS, SG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2023
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

KM 11.7 PR-2
BAYAMON PR
00959
US

IV. Provider business mailing address

KM 11.7 PR-2
BAYAMON PR
00959
US

V. Phone/Fax

Practice location:
  • Phone: 787-620-8181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number023978
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number001288
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: