Healthcare Provider Details

I. General information

NPI: 1619614690
Provider Name (Legal Business Name): FRANCISCO GABRIEL RIVERA EMANUELLI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1614 CALLE SANTA BIBIANA
SAN JUAN PR
00926-4113
US

IV. Provider business mailing address

1614 CALLE SANTA BIBIANA
SAN JUAN PR
00926-4113
US

V. Phone/Fax

Practice location:
  • Phone: 787-718-5979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17370
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: