Provider Demographics
NPI:1841215035
Name:RIVERA-ZAYAS, JAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:
Last Name:RIVERA-ZAYAS
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 1357
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-1357
Mailing Address - Country:US
Mailing Address - Phone:787-654-8400
Mailing Address - Fax:787-654-8400
Practice Address - Street 1:PLAZA EL JIBARO
Practice Address - Street 2:570 AVENIDA EL JIBARO CARRETERA 172 INTERIOR SUITE 2
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-3693
Practice Address - Country:US
Practice Address - Phone:787-739-9898
Practice Address - Fax:787-739-9899
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13113208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20276Medicare ID - Type Unspecified
PRH80716Medicare UPIN