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NPI Code Detail

MEDICARE: DR. JORGE RIVERA M.D.

MEDICARE: DR. JORGE 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
1207R00000XInternal Medicine Physician11818PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111818OTHERPRLICENCE

General Provider Information

NPI Number : 1285626408
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JORGE RIVERA M.D.
Provider Business Mailing Address
First Line : PO BOX 1256
Second Line :
City : GUANICA
State : PR
Zip : 00653-1256
Country : US
Telephone Number : 787-821-5258
Fax Number : 787-821-3116
Provider Business Practice Location Address
First Line : 26 CALLE YAGUER
Second Line :
City : GUANICA
State : PR
Zip : 00653
Country : US
Telephone Number : 787-821-5258
Fax Number : 787-821-3116
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 05/30/2019

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Directions to “ DR. JORGE RIVERA M.D.” Practice Location

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