Healthcare Provider Details

I. General information

NPI: 1497619746
Provider Name (Legal Business Name): RIVERA RAMIREZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

PO BOX 227
SAN GERMAN PR
00683-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-560-4314
  • Fax:
Mailing address:
  • Phone: 787-560-4314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PEDRO ORLANDO RIVERA RAMIREZ DE ARELLANO
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 787-560-4314