Provider Demographics
NPI:1760515837
Name:DEL RIO FERRER, JOSE M (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:M
Last Name:DEL RIO FERRER
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:PO BOX 2891
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-2891
Mailing Address - Country:US
Mailing Address - Phone:787-834-6985
Mailing Address - Fax:787-805-2222
Practice Address - Street 1:55 CALLE VIRGINIA
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3820
Practice Address - Country:US
Practice Address - Phone:787-834-6985
Practice Address - Fax:787-805-2222
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11126207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG04559Medicare UPIN