Healthcare Provider Details

I. General information

NPI: 1699696203
Provider Name (Legal Business Name): RM GASTROENTEROLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 AVE PONCE DE LEON STE 402
SAN JUAN PR
00907-4033
US

IV. Provider business mailing address

155 AVE HOSTOS APT G116
SAN JUAN PR
00918-4232
US

V. Phone/Fax

Practice location:
  • Phone: 787-723-9595
  • Fax:
Mailing address:
  • Phone: 787-307-6042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUCIA RIVERA MATOS
Title or Position: EMPLOYEE
Credential: MD
Phone: 787-307-6042