Provider Demographics
NPI:1336202753
Name:ROBERTO J SEIN & RAFAEL M RIVERA PTR
Entity type:Organization
Organization Name:ROBERTO J SEIN & RAFAEL M RIVERA PTR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:SEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-753-4631
Mailing Address - Street 1:AVE. DE DIEGO 216 SEIN MEDICAL PLAZA
Mailing Address - Street 2:REPARTO METROPOLITANO
Mailing Address - City:RIO PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-753-4631
Mailing Address - Fax:787-753-4631
Practice Address - Street 1:AVE DE DIEGO #201
Practice Address - Street 2:PLAZA SAN FRANCISCO OFICE #30
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-753-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5636261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR27499Medicare ID - Type Unspecified
PRC77543Medicare UPIN