Provider Demographics
NPI:1255365730
Name:BARRETO-SOLA, LUIS R (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:BARRETO-SOLA
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 1269
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-1269
Mailing Address - Country:US
Mailing Address - Phone:787-743-6050
Mailing Address - Fax:787-745-4745
Practice Address - Street 1:500 AVE DEGETAU
Practice Address - Street 2:HIMA PLAZA 1 SUITE # 713
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-7301
Practice Address - Country:US
Practice Address - Phone:787-743-6050
Practice Address - Fax:787-745-4745
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10590207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10590OtherSTATE LICENSE
PRF-36335Medicare UPIN
PR83304Medicare ID - Type Unspecified