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NPI Code Detail

MEDICARE: DR. JUAN PEDRO RIVERA M.D.

MEDICARE:  DR. JUAN PEDRO RIVERA  M.D.
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
12084N0400XNeurology PhysicianME115771FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LF451OTHERFLFL MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205836202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN PEDRO RIVERA M.D.
Provider Business Mailing Address
First Line : LANDSTUHL REGIONAL MEDICAL CENTER
Second Line : UNIT 33100
City : APO
State : AE
Zip : 09180-3100
Country : US
Telephone Number : 314-590-5837
Fax Number :
Provider Business Practice Location Address
First Line : LANDSTUHL REGIONAL MEDICAL CENTER
Second Line : UNIT 33100
City : APO
State : AE
Zip : 09180-3100
Country : US
Telephone Number : 314-590-5837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2005
Last Update Date : 08/14/2023

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Directions to “ DR. JUAN PEDRO RIVERA M.D.” Practice Location

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