MEDICARE: MR. ROBERTO LUIS NEVARES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0105X	Surgery of the Hand (Surgery) Physician	6844	PR
2	2086S0127X	Trauma Surgery Physician	6844	PR

General Provider Information

NPI Number	:	1023095973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERTO LUIS NEVARES MD

Provider Business Mailing Address
First Line	:	29 WASHINGTON ST
Second Line	:	STE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1509
Country	:	US
Telephone Number	:	787-722-6220
Fax Number	:	787-722-4950

Provider Business Practice Location Address
First Line	:	29 WASHINGTON ST
Second Line	:	STE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1509
Country	:	US
Telephone Number	:	787-722-6220
Fax Number	:	787-722-4950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	09/11/2025

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