Provider Demographics
NPI:1972149540
Name:ZAMBRANA RIVERA, JOSE RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:RAFAEL
Last Name:ZAMBRANA 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:VALLE HUCARES
Mailing Address - Street 2:189 CEIBA ST
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:787-624-9974
Mailing Address - Fax:
Practice Address - Street 1:ACEROLA ST COTO LAUREL
Practice Address - Street 2:HOSPITAL SAN CRISTOBAL
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-848-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21592208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice