Provider Demographics
NPI:1689603169
Name:OLIVARI, LUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:
Last Name:OLIVARI
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 1:2000 CARR 8177
Mailing Address - Street 2:SUITE 26, PMB 226
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3733
Mailing Address - Country:US
Mailing Address - Phone:787-273-8053
Mailing Address - Fax:787-781-4555
Practice Address - Street 1:T3-9 CALLE SANDALIO ALONSO
Practice Address - Street 2:LAS LOMAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3632
Practice Address - Country:US
Practice Address - Phone:787-273-8053
Practice Address - Fax:787-781-4555
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6080207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR97553OtherTRIPLE S, INC. (SSS)
PR52-06080OtherPLAN DE SALUD U.I.A.
PR600098OtherMMM HEALTH CARE
PR2518OtherIMC (FIRST MEDICAL)
PR9220032OtherHUMANA INSURANCE
PR224062OtherPREFERRED HEALTH CARE
PR066079OtherCRUZ AZUL
PRSE-0548OtherPALIC PROVIDER NETWORK
PR4087OtherPMC MEDICARE CHOICE
PR600098OtherMMM HEALTH CARE
PR0097553Medicare ID - Type Unspecified