MEDICARE: BONATI MEDICA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1831051960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BONATI MEDICA LLC

Provider Business Mailing Address
First Line	:	2197 BLVD LUIS A FERRE
Second Line	:	STE 103
City	:	PONCE
State	:	PR
Zip	:	00717-0605
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2197 BLVD LUIS A FERRE
Second Line	:	STE 103
City	:	PONCE
State	:	PR
Zip	:	00717-0605
Country	:	US
Telephone Number	:	787-987-8822
Fax Number	:

Authorized Official
Title or Position	:	DR
Name	:	ANA GABRIELA SERRANO LOPEZ
Credential	:	MD
Telephone Number	:	787-341-4262

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	05/05/2026

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