Provider Demographics
NPI:1780355511
Name:RIOPEDRE CUEVAS, JASON JOSEL (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:JOSEL
Last Name:RIOPEDRE CUEVAS
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:PO BOX 2792
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-2792
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14 CALLE 25 DE JULIO
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-492-0260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2024-04-23
Deactivation Date:2022-01-04
Deactivation Code:
Reactivation Date:2024-04-08
Provider Licenses
StateLicense IDTaxonomies
PR23650208D00000X
PR776363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice