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NPI Code Detail

MEDICARE: DR. MIGUEL EFRAIN RIVERA DMD

MEDICARE: DR. MIGUEL EFRAIN RIVERA DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry1244PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
141128OTHERTRIPLE S
22696OTHERINTERNATIONAL MEDICAL CAR
37570021OTHERHUMANA
4206605OTHERPREFERRED HEALTH
5040694OTHERPRLA CRUZ AZUL

General Provider Information

NPI Number : 1124029723
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MIGUEL EFRAIN RIVERA DMD
Provider Business Mailing Address
First Line : 69 CALLE CELIS AGUILERA
Second Line : P O BOX 266
City : SANTA ISABEL
State : PR
Zip : 00757-2528
Country : US
Telephone Number : 787-845-3071
Fax Number :
Provider Business Practice Location Address
First Line : 69 CALLE CELIS AGUILERA
Second Line : PLAZA DEL PARQUE # 3
City : SANTA ISABEL
State : PR
Zip : 00757-2528
Country : US
Telephone Number : 787-845-3071
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 07/08/2007

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