Provider Demographics
NPI:1699445262
Name:RIVERA BETANCOURT, NAYIB J (MD)
Entity type:Individual
Prefix:DR
First Name:NAYIB
Middle Name:J
Last Name:RIVERA BETANCOURT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NAYIB
Other - Middle Name:J
Other - Last Name:RIVERA BETANCOURT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:URB. MARBELLA #17
Mailing Address - Street 2:CALLE PALMERAS
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751
Mailing Address - Country:US
Mailing Address - Phone:787-400-1273
Mailing Address - Fax:
Practice Address - Street 1:BO. RABANAL
Practice Address - Street 2:CARR. 173 KM 6
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-400-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-15
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22548208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice