Healthcare Provider Details

I. General information

NPI: 1821827536
Provider Name (Legal Business Name): YADMARIE RIVERA TORRES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2213 PONCE BYP
PONCE PR
00717-1310
US

IV. Provider business mailing address

BARRIO MONACILLOS AREA CENTRO MEDICO
SAN JUAN PR
00935-0001
US

V. Phone/Fax

Practice location:
  • Phone: 787-840-8686
  • Fax:
Mailing address:
  • Phone: 787-763-4149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24903
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: