Provider Demographics
NPI:1760405344
Name:RIOS-CERVANTES, JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:
Last Name:RIOS-CERVANTES
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 1:10-7 AVE AGUAS BUENAS
Mailing Address - Street 2:SANTA ROSA
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-6611
Mailing Address - Country:US
Mailing Address - Phone:787-786-8520
Mailing Address - Fax:787-786-8520
Practice Address - Street 1:10-7 AVE AGUAS BUENAS
Practice Address - Street 2:SANTA ROSA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-6611
Practice Address - Country:US
Practice Address - Phone:787-786-8520
Practice Address - Fax:787-786-8520
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR61642084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28214Medicare ID - Type Unspecified