Provider Demographics
NPI:1215906995
Name:BEAZ RIVERA, LUIS F (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:F
Last Name:BEAZ RIVERA
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:MANSION REAL
Mailing Address - Street 2:CALLE REY FERNANDO 129
Mailing Address - City:COTTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-840-4117
Mailing Address - Fax:
Practice Address - Street 1:MANSION REAL
Practice Address - Street 2:CALLE REY FERNANDO 129
Practice Address - City:COTTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-812-3571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10634207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF95153Medicare UPIN