Healthcare Provider Details

I. General information

NPI: 1306928833
Provider Name (Legal Business Name): DARIO LUIS REYES RIVERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARKVILLE N-38 MCKINLEY ST
GUAYNABO PR
00969
US

IV. Provider business mailing address

PARKVILLE, N-38 MCKINLEY
GUAYNABO PR
00969
US

V. Phone/Fax

Practice location:
  • Phone: 787-720-1773
  • Fax:
Mailing address:
  • Phone: 787-720-1773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number9710
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: