MEDICARE: ELBA ROSA MARTIN REYES 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	207RP1001X	Pulmonary Disease Physician	16147	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16147	OTHER	PR	MEDICAL LISENCE

General Provider Information

NPI Number	:	1003808742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELBA ROSA MARTIN REYES MD

Provider Business Mailing Address
First Line	:	87 CARRET 20 COND LA ARBOLEDA
Second Line	:	APT 1603
City	:	GUAYNABO
State	:	PR
Zip	:	00966
Country	:	US
Telephone Number	:	787-782-4156
Fax Number	:

Provider Business Practice Location Address
First Line	:	AVE SAN PATRICIO # 101
Second Line	:	MARAMAR PLAZA SUITE 1240
City	:	GUAYNABO
State	:	PR
Zip	:	00968-4484
Country	:	US
Telephone Number	:	787-508-5445
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/07/2016

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Directions to “ ELBA ROSA MARTIN REYES MD” Practice Location

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