1285650192 NPI number — DR. JOSE A. ZAYAS RIVAS M.D.

Table of content: DR. JOSE A. ZAYAS RIVAS M.D. (NPI 1285650192)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285650192 NPI number — DR. JOSE A. ZAYAS RIVAS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZAYAS RIVAS
Provider First Name:
JOSE
Provider Middle Name:
A.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285650192
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB. VILLA MADRID
Provider Second Line Business Mailing Address:
CALLE 15 O1
Provider Business Mailing Address City Name:
COAMO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00769
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-529-0945
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DESVIO CALLE LUIS MUNOZ MARIN
Provider Second Line Business Practice Location Address:
CARR 138
Provider Business Practice Location Address City Name:
COAMO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00769-0076
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-803-7017
Provider Business Practice Location Address Fax Number:
787-803-0115
Provider Enumeration Date:
07/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 146M00000X , with the licence number:  13759 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)