Provider Demographics
NPI:1952304446
Name:RIVERA-MONTAEZ, REHUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:REHUEL
Middle Name:
Last Name:RIVERA-MONTAEZ
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 70-250
Mailing Address - Street 2:SUITE 293
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936
Mailing Address - Country:US
Mailing Address - Phone:787-286-2930
Mailing Address - Fax:787-292-0222
Practice Address - Street 1:TORRE DE HIMA SUITE 117
Practice Address - Street 2:AVE LUIS MUOZ RIVERA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-286-2930
Practice Address - Fax:787-292-0222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6976208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE43406Medicare UPIN
PR28293Medicare ID - Type UnspecifiedPROVIDER NUMBER