Provider Demographics
NPI:1801838982
Name:ZAYAS CABRERA, RICHARD IVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IVAN
Last Name:ZAYAS CABRERA
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 1766
Mailing Address - Street 2:
Mailing Address - City:COAMO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00769
Mailing Address - Country:UM
Mailing Address - Phone:787-803-1248
Mailing Address - Fax:787-803-1248
Practice Address - Street 1:A-17 CALLE IMPERIO
Practice Address - Street 2:MANSIONES DE COAMO
Practice Address - City:COAMO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00769
Practice Address - Country:UM
Practice Address - Phone:787-803-1248
Practice Address - Fax:787-803-1248
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14510208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14510OtherSTATE LICENSE
PRDM14697-7OtherSTATE NARCOTIC LICENSE
PRBZ7998618OtherDEA NUMBER
PRI-01022Medicare UPIN
PR0022274Medicare ID - Type UnspecifiedPROVIDER NUMBER