Healthcare Provider Details

I. General information

NPI: 1205767068
Provider Name (Legal Business Name): JOSIAS ISMEL CONTRERAS REYES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO DR JOSE CELSO BARBOSA ESCUELA DE ENFERMERIA
SAN JUAN PR
00921
US

IV. Provider business mailing address

1051 CALLE 3 SE APT 601
SAN JUAN PR
00921-3024
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 646-956-6459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: