Healthcare Provider Details

I. General information

NPI: 1972426518
Provider Name (Legal Business Name): RIVERA ORTIZ SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 AVE ASHFORD
SAN JUAN PR
00907-1511
US

IV. Provider business mailing address

1413 AVE PONCE DE LEON STE 401 PMB 059
SAN JUAN PR
00907-4023
US

V. Phone/Fax

Practice location:
  • Phone: 787-722-6544
  • Fax:
Mailing address:
  • Phone: 787-224-1909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ELAINE RIVERA ORTIZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-224-1909