Provider Demographics
NPI:1285650192
Name:ZAYAS RIVAS, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:ZAYAS RIVAS
Suffix:
Gender:M
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:URB. VILLA MADRID
Mailing Address - Street 2:CALLE 15 O1
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:939-529-0945
Mailing Address - Fax:
Practice Address - Street 1:DESVIO CALLE LUIS MUNOZ MARIN
Practice Address - Street 2:CARR 138
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-0076
Practice Address - Country:US
Practice Address - Phone:787-803-7017
Practice Address - Fax:787-803-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13759146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20846ZAMedicare ID - Type UnspecifiedTRIPLE- S