Healthcare Provider Details

I. General information

NPI: 1609429091
Provider Name (Legal Business Name): ANGELICA MARIE NIEVES-RIVERA MD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MMC PROFESIONAL PLZ
MANATI PR
00674-4652
US

IV. Provider business mailing address

MMC PROFESIONAL PLZ
MANATI PR
00674-4652
US

V. Phone/Fax

Practice location:
  • Phone: 787-884-2558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number025062
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: