| Doctor Name: | MARIELA MELISSA RIVERA AGOSTO |
| NPI Number: | 1407278484 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 015217-I |
| Business Practice Address: | Hospital Oncologico Dr. I. Gonzalez Martinez Hospital Centro Medico Rio Piedras, PR - 00935 |
| Business Phone Number: | 7877634149 |
| Business Fax Number: | |
| Mailing Address: | Po Box 191811, Hospital Oncologico Dr. I. Gonzalez Martinez SAN JUAN |
| State: | PR |
| Postal Code: | 009191811 |
| Phone Number: | 7877634149 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2014 |
| NPI Last Update Date: | 01/10/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 015217-I |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |