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NPI Code Detail

MEDICARE: DR. LUCAS JORGE RIOSSANTONI M.D.

MEDICARE: DR. LUCAS JORGE RIOSSANTONI M.D.
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
1208D00000XGeneral Practice Physician5130PR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12381OTHERPRPREFERRED MEDICARE CHOICE
2100354WOTHERPRMEDICARE Y MUCHO MAS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
31130OTHERFIRST MEDICAL HEALTH PLAN
4582626003OTHERPRLA CRUZ AZUL
501802OTHERPRAMERICAN HEALTH INC.
666011111101OTHERPRMCS MEDICAL CARD SYSTEM
76530012OTHERPRHUMANA HEALTH PLAN
826400OTHERPRREFORMA DE SSS
9201762OTHERPRPREFERRED HEALTH

General Provider Information

NPI Number : 1669542486
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUCAS JORGE RIOSSANTONI M.D.
Provider Business Mailing Address
First Line : PO BOX 1303
Second Line :
City : GUANICA
State : PR
Zip : 00653-1303
Country : US
Telephone Number : 787-821-2320
Fax Number : 787-821-7362
Provider Business Practice Location Address
First Line : 12 CALLE YAGUER
Second Line :
City : GUANICA
State : PR
Zip : 00653-2533
Country : US
Telephone Number : 787-821-2320
Fax Number : 787-821-7362
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 03/24/2026

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