Provider Demographics
NPI:1992782551
Name:REINA-SANABRIA, RICARDO JESUS (MD)
Entity type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:JESUS
Last Name:REINA-SANABRIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 GRAND BLVD PASEOS
Mailing Address - Street 2:SUITE 112 MSC 313
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5955
Mailing Address - Country:US
Mailing Address - Phone:787-287-4938
Mailing Address - Fax:
Practice Address - Street 1:576 AVE CESAR GONZALEZ
Practice Address - Street 2:SUITE 506 DORAL BANK CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5022
Practice Address - Country:US
Practice Address - Phone:787-772-1007
Practice Address - Fax:787-772-1009
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13805207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1989OtherPREFERRED MEDICARE CHOICE
PR2002639OtherACAA
PR9170108OtherHUMANA HEALTH
PR062032OtherCRUZ AZUL
PR13713805OtherGLOBAL HEALTH
PR20980REOtherSSS
PR9170108OtherHUMANA INSURANCE
PR2002639OtherACAA
PR0020980Medicare ID - Type Unspecified