Healthcare Provider Details

I. General information

NPI: 1750940292
Provider Name (Legal Business Name): VERONICA MICHELLE RIVERA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2019
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 47.7
MANATI PR
00674-8513
US

IV. Provider business mailing address

54 CALLE ORQUIDEA
TOA ALTA PR
00953-3610
US

V. Phone/Fax

Practice location:
  • Phone: 787-526-6983
  • Fax:
Mailing address:
  • Phone: 787-529-6983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number23946
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: