Provider Demographics
NPI:1316141682
Name:SALAS-RIVERA, JAVIER CONCEPCION (MD)
Entity type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:CONCEPCION
Last Name:SALAS-RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROAD 2 126.4KM
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605
Mailing Address - Country:US
Mailing Address - Phone:787-882-2700
Mailing Address - Fax:787-882-4605
Practice Address - Street 1:MIRAMAR STREET 209
Practice Address - Street 2:BO. GUANIQUILLA, PARCELAS NUEVA
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:939-969-4257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR144682083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR14468OtherMEDICAL LIC.