Provider Demographics
NPI:1548473424
Name:BELTRE, LUIS (MD)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:
Last Name:BELTRE
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:URB. REPARTO METROPOLITANO CALLE 57 SE #873
Mailing Address - Street 2:CALLE 57 SE #873
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00921
Mailing Address - Country:US
Mailing Address - Phone:787-607-8295
Mailing Address - Fax:
Practice Address - Street 1:873 CALLE 57 SE
Practice Address - Street 2:URB. REPARTO METROPOLITANO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-2311
Practice Address - Country:US
Practice Address - Phone:787-607-8295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15342208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice