Provider Demographics
NPI:1962213900
Name:REYES RIVAS, DENISSE (MD)
Entity type:Individual
Prefix:DR
First Name:DENISSE
Middle Name:
Last Name:REYES RIVAS
Suffix:
Gender:
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 227
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-9998
Mailing Address - Country:US
Mailing Address - Phone:787-940-3775
Mailing Address - Fax:
Practice Address - Street 1:5 CALLE BARBOSA
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2956
Practice Address - Country:US
Practice Address - Phone:787-940-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24202208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice