Healthcare Provider Details

I. General information

NPI: 1982683983
Provider Name (Legal Business Name): JOSE FRANCISCO RIVERA VIERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET 1 LOT B-1 VILLAS DE LOIZA
LOIZA PR
00729
US

IV. Provider business mailing address

PO BOX 459
CANOVANAS PR
00729-0459
US

V. Phone/Fax

Practice location:
  • Phone: 787-876-2498
  • Fax: 787-256-5814
Mailing address:
  • Phone: 787-876-2498
  • Fax: 787-256-5814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number4368
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: