Provider Demographics
NPI:1619936085
Name:SABATER, ENRIQUE A (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:A
Last Name:SABATER
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 1:1842 CALLE REINA DE LAS FLORES
Mailing Address - Street 2:URB SANTA MARIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-6820
Mailing Address - Country:US
Mailing Address - Phone:787-232-2787
Mailing Address - Fax:
Practice Address - Street 1:1842 CALLE REINA DE LAS FLORES
Practice Address - Street 2:URB SANTA MARIA
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-6820
Practice Address - Country:US
Practice Address - Phone:787-232-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-22
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN372272085R0202X, 2085R0204X
PR167332085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN890818400Medicaid
PR26478OtherPTAN
PR26478OtherPTAN
F84589Medicare UPIN
MN300054520Medicare ID - Type UnspecifiedRAILROAD