Doctor Name: | DR. CANDICE MARIE RIVERA |
NPI Number: | 1477799674 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 19110 |
Business Practice Address: | Manati Medical Center Carretera # 2 Manati, PR - 00674 |
Business Phone Number: | 7876213700 |
Business Fax Number: | |
Mailing Address: | 368 Calle Trinitaria, ISABELA |
State: | PR |
Postal Code: | 006625021 |
Phone Number: | 7878727485 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2008 |
NPI Last Update Date: | 08/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 19110 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |