Healthcare Provider Details

I. General information

NPI: 1316464357
Provider Name (Legal Business Name): ALEJANDRO L ALBORS RIVERA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 04/30/2024
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9WWG 6G6, PASEO DR. JOSE CELSO BARBOSA
SAN JUAN PR
00921
US

IV. Provider business mailing address

3B3 CALLE FAIRVIEW 42ND
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-3704
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number22760
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22760
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: