Healthcare Provider Details

I. General information

NPI: 1750390712
Provider Name (Legal Business Name): OLGA N. GARCIA-RIVERA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE LAUREL HOSPITAL REGIONAL BAYAMON CENTRO PEDIATRICO DE BAYAMON
BAYAMON PR
00956
US

IV. Provider business mailing address

1019 AVE. LUIS VIGOREAUX APT. 16-E ,DORAL PLAZA
GUAYNABO PR
00966
US

V. Phone/Fax

Practice location:
  • Phone: 787-778-4747
  • Fax:
Mailing address:
  • Phone: 787-706-0972
  • Fax: 787-786-8615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5339
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: