Doctor Name: | DR. RAFAEL DIAZ RIVERA |
NPI Number: | 1124091418 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | LIC14134 |
Business Practice Address: | Condo Medicina Center Altos Correo Rio Piedras Oficina 704 Calle Arzuaga #112 Rio Piedras, PR - 00928 |
Business Phone Number: | 7876459783 |
Business Fax Number: | |
Mailing Address: | Calle Gran Canyon U2-4, Park Gardens SAN JUAN |
State: | PR |
Postal Code: | 00926 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 02/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | LIC14134 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |