Healthcare Provider Details

I. General information

NPI: 1205761822
Provider Name (Legal Business Name): ISLAND ORTHO SPECIALISTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 CALLE VICTORIA
HUMACAO PR
00791-4493
US

IV. Provider business mailing address

50 CALLE VICTORIA
HUMACAO PR
00791-4493
US

V. Phone/Fax

Practice location:
  • Phone: 787-218-5876
  • Fax:
Mailing address:
  • Phone: 787-218-5876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CARLOS MANUEL CAMPA MALDONADO
Title or Position: ORTHOPAEDIC SURGEON
Credential: MD
Phone: 787-218-5876