Healthcare Provider Details

I. General information

NPI: 1306840160
Provider Name (Legal Business Name): ANTHONY RAPHAEL RIVERA LINARES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54-12 AVE MAIN
BAYAMON PR
00959-6581
US

IV. Provider business mailing address

CALLE 8 G15 RIVERSIDE PARK
BAYAMON PR
00961-8584
US

V. Phone/Fax

Practice location:
  • Phone: 787-251-7614
  • Fax: 787-251-7608
Mailing address:
  • Phone: 787-251-7614
  • Fax: 787-251-7608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14466
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: