| Organization Name: | CONSULTORIO MEDICO DR. RIVERA |
| NPI Number: | 1033117023 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUIS A. RIVERA (M.D.) |
| Mailing Address: | Street 21 S3-2 Las Lomas San Juan Pr Pmb Po Bx 7891 Guaynabo Pr. 00970 San Juan |
| State: | PR US |
| Postal Code: | 00921 |
| Phone Number: | 7877925566 |
| Fax Number: | 7877824615 |
| NPI Enumeration Date: | 07/13/2005 |
| NPI Last Update Date: | 08/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 5686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |