Provider Demographics
NPI:1740343052
Name:BARRERAS RINCON, JOSE R (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:R
Last Name:BARRERAS RINCON
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 1:378 CALLE REY JORGE
Mailing Address - Street 2:LA VILLA DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3225
Mailing Address - Country:US
Mailing Address - Phone:787-708-0899
Mailing Address - Fax:787-789-3133
Practice Address - Street 1:378 CALLE REY JORGE
Practice Address - Street 2:LA VILLA DE TORRIMAR
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-3225
Practice Address - Country:US
Practice Address - Phone:787-708-0899
Practice Address - Fax:787-789-3133
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11871261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11871OtherSTATE LICENCE