Provider Demographics
NPI:1417328717
Name:DR. JOSE R ARROYO MATOS CSP
Entity Type:Organization
Organization Name:DR. JOSE R ARROYO MATOS CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:ARROYO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-735-4887
Mailing Address - Street 1:PO BOX 1077
Mailing Address - Street 2:
Mailing Address - City:AIBONITO
Mailing Address - State:PR
Mailing Address - Zip Code:00705-1077
Mailing Address - Country:US
Mailing Address - Phone:787-735-4887
Mailing Address - Fax:
Practice Address - Street 1:156 CALLE BALDORIOTY N
Practice Address - Street 2:
Practice Address - City:AIBONITO
Practice Address - State:PR
Practice Address - Zip Code:00705-3218
Practice Address - Country:US
Practice Address - Phone:787-735-4887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR81962083P0901X, 2083X0100X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR29578ARMedicare PIN
PRE65312Medicare UPIN