Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 2107 | PR |
Y | 213EG0000X | General Practice | 2107 | PR |
N | 1223P0700X | Prosthodontist | 2107 | PR |
NPI | 1235126707 |
---|---|
Provider Name | Dr. Jose Luis Rivera-Zayas |
First Address | San Juan, PR 00936-1477 |
Second Address | San Juan, PR 00918-3756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 24/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1166 | FIRST MEDICAL DENTAL (01) | PR |
206198 | UTI DENTAL (01) | PR |
41787 | CRUZ AZUL DENTAL PLAN (01) | PR |
42122RI | TRIPLE-S DENTAL PLAN (01) | PR |
9690002 | HUMANA HEALTH PLAN PR (01) | PR |
9690002 | HUMANA HEALTH REFORM (01) | PR |