Services
Virtual primary care in Puerto Rico
Virtual primary care in Puerto Rico means an ongoing relationship with one doctor, by video: new concerns, prevention, lab tests and follow-up of your conditions. With us that doctor is Dr. Diana Nieves Castro, MD, a Puerto Rico-licensed general practice physician who sees adults and children of all ages, in English or Spanish. We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
Is it an emergency? Call 911.

Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Chest pain or pressure
- Trouble breathing
- A drooping face, weakness on one side or trouble speaking
- A serious injury or bleeding that won't stop
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On this page(9)
What virtual primary care is
Primary care is the doctor who knows your history and looks after you over time, not only when something hurts. It covers most of what a person needs in a year: new concerns, check-ins, preventive tests, medications and the long-term care of ongoing conditions.
If it's hard to get in with a primary care doctor, by video Dr. Diana Nieves Castro sees you wherever you are on the island, and because it's the same doctor each time, you don't have to start your story from scratch. Just moved to the island? A doctor who speaks English can be your regular doctor by video.
Before you leave home
Why a video visit
For anything that isn’t an emergency, compare what each option takes.
| Comparison | Video visit | Emergency room | CDT or doctor’s office |
|---|---|---|---|
| Getting there | From home: join from your phone, tablet or computer. | Drive and find parking. | Drive and find parking. |
| Waiting room | Skip the waiting room: join from wherever you are in Puerto Rico. | Yes, a waiting room. | Yes, a waiting room. |
| Hours and time | We do not publish a wait time. Request a visit online 24/7 — we confirm your time by email or text. | In Puerto Rico, a median of 4 h 52 min from arrival to departure for patients sent home (US: 2 h 42 min; Oct 2024–Sep 2025).1,2 | An in-person visit takes about 2 hours on average, including travel.3 |
| Price | US$79 visit · US$49 follow-up · US$35 forms. You see it before you pay; no insurance needed. | Depends on your insurance and on what is done. | Depends on your insurance and on what is done. |
| Language | Spanish or English, with the same doctor. | Depends on the place. | Depends on the place. |
| Prescriptions | If appropriate, the doctor prescribes and we send your prescription to your pharmacy. | Yes, if needed. | Yes, if needed. |
| When to go in person | If the doctor needs to examine you in person or run a test, she tells you and guides you. | In an emergency: chest pain, trouble breathing, weakness on one side or bleeding that won’t stop. Call 911. | If you need stitches, an X-ray or a test on the spot. |
For problems that are not emergencies. In an emergency, call 911.
Table sources
- 1. CMS Care Compare, “Timely and Effective Care – State”, measure OP-18b: median time in the emergency department, arrival to departure, for patients sent home (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 2. CMS Care Compare, “Timely and Effective Care – National”, measure OP-18b (US figure) (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 3. Ray KN et al., “Opportunity costs of ambulatory medical care in the United States,” Am J Manag Care 2015;21(8):567-74 (US data, 2003–2010) (opens in a new tab) (accessed 2026-10-02)
We found no published source for what a patient pays at an ER or a CDT in Puerto Rico, so we give no figure.
How we care for you by video
The doctor asks about your health, medications, allergies and family history, and has you show her what matters on camera. If you have a blood pressure monitor, glucose meter, scale or thermometer at home, keep it handy: your readings help a lot.
You leave with a plan: treatment, lifestyle changes, lab tests, or an in-person visit when a physical exam is needed. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your primary care visit in 3 steps
Request a visit online 24/7 — we confirm your time by email or text.
Request your visit and pay by card.
You are charged when you request it, with a full refund if the visit can't take place.
We confirm your time and send your secure video link.
It works on your phone, tablet or computer.
See the doctor by video
and leave with a clear plan for your health.
Price
A primary care visit is a US$79 doctor visit, the same price for every age, with no membership. We don't bill insurance; ask for an itemized receipt (superbill) if you want to file a claim yourself.
After that, a refill of a medicine you already take or a review of your lab results is a US$49 follow-up visit.
Video visit
Doctor visit
US$79
For a new problem, urgent care (non-emergencies), primary care, children, birth control, STIs, skin and acne, and visitors. Includes a doctor's note if you need one.
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
What virtual primary care in Puerto Rico covers
The most common reasons for a primary care visit:
- New concerns that aren't urgent: pain that won't go away, fatigue, changes in weight or sleep, heartburn or headaches.
- Prevention: which tests are right for your age and history, and how to lower your risk of heart disease or diabetes.
- Ongoing conditions such as high blood pressure, diabetes, cholesterol or thyroid disease. See chronic care.
- Your medications: reviewing what you take, side effects and renewals.
- Kids and teens, with a parent or legal guardian on camera. See online doctor visits for kids.
- Sexual and reproductive health, such as birth control or STI testing.
Treatment and preventive lab work
The doctor tells you which preventive tests make sense for you. For example, the U.S. Preventive Services Task Force (USPSTF) recommends blood pressure screening for all adults 18 and older.
When a test would help, she gives you a lab order for a lab near you, such as glucose or A1C, cholesterol, thyroid, kidney function or a urinalysis. You then go over the results together and adjust the plan.
When to go to the ER
Video visits are not for emergencies. If you have chest pain, trouble breathing, signs of a stroke or a serious injury, call 911. For a non-emergency that can't wait, use virtual urgent care.
Book a primary care visit
Book a visit and choose Doctor visit (US$79). For a patient under 21, a parent with patria potestad (parental authority) or a legal guardian must stay on camera for the whole visit.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can the doctor be my primary care doctor?
Do you see adults and kids?
Do you take insurance?
Can I use you if I already have a primary care doctor?
Need to see the doctor?
US$79Doctor visit
- You’re charged when you request the visit.
- Full refund if the visit can’t take place
Request a visit online 24/7 — we confirm your time by email or text.
Doctor visit: US$79 — BookAbout this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-02
Sources (5)
- USPSTF: Hypertension in adults, screening (opens in a new tab) (accessed 2026-09-30)
- Lab tests (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-09-30)
- CDC: A1C test for diabetes and prediabetes (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018 (LexJuris, Spanish) (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico medical license lookup (Department of Health) (opens in a new tab) (accessed 2026-09-29)
