Provider Demographics
NPI:1033153630
Name:MATOS RIVERA, LINKA (MD)
Entity Type:Individual
Prefix:
First Name:LINKA
Middle Name:
Last Name:MATOS RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE PINERO # 291
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-4003
Mailing Address - Country:US
Mailing Address - Phone:787-430-7246
Mailing Address - Fax:939-338-0885
Practice Address - Street 1:AVE PINERO # 291
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4003
Practice Address - Country:US
Practice Address - Phone:787-430-7246
Practice Address - Fax:939-338-0885
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14372207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14372OtherLICENSE
PR150957Medicare UPIN