Healthcare Provider Details

I. General information

NPI: 1811816101
Provider Name (Legal Business Name): RIVERA-SERRANO HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 AVE GENERAL VALERO
FAJARDO PR
00738-3998
US

IV. Provider business mailing address

PO BOX 456
JUNCOS PR
00777-0456
US

V. Phone/Fax

Practice location:
  • Phone: 787-800-2219
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIBEL RIVERA MEJIAS
Title or Position: PRESIDENT
Credential: MD
Phone: 787-999-9999