| Doctor Name: | DR. FERNANDO J RIVERA |
| NPI Number: | 1073687992 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 16659 |
| Business Practice Address: | 909 Tito Castro Ave Torre Medica Hosp San Lucas Suite 105 Ponce, PR - 007164802 |
| Business Phone Number: | 7876511435 |
| Business Fax Number: | 7876511436 |
| Mailing Address: | 2756 Calle El Monte, Urb. El Monte PONCE |
| State: | PR |
| Postal Code: | 007164802 |
| Phone Number: | 7874295151 |
| Fax Number: | |
| NPI Enumeration Date: | 11/20/2006 |
| NPI Last Update Date: | 02/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16659 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |