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General NPI Number Information
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NPI Number | 1982686051
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Entity Type | Individual
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Provider Name | ENID M MATEO-REYES M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1441 AVE ROOSEVELT THIRD FLOOR
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City | SAN JUAN
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State | PR
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Zip | 00920-2717
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Country | US
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Telephone | 787-749-4055
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Fax | 787-706-2816
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Provider Business Mailing Address
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Address Line | 200 AVE JESUS T PINERO HATO REY PLAZA APT 7A
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City | SAN JUAN
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State | PR
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Zip | 00918-4109
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Country | US
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Telephone | 787-763-9647
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Fax | 787-706-2816
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5736
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License Number State | PR
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