Healthcare Provider Details

I. General information

NPI: 1831051960
Provider Name (Legal Business Name): BONATI MEDICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2197 BLVD LUIS A FERRE STE 103
PONCE PR
00717-0605
US

IV. Provider business mailing address

2197 BLVD LUIS A FERRE STE 103
PONCE PR
00717-0605
US

V. Phone/Fax

Practice location:
  • Phone: 787-987-8822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANA GABRIELA SERRANO LOPEZ
Title or Position: DR
Credential: MD
Phone: 787-341-4262