Healthcare Provider Details

I. General information

NPI: 1427088822
Provider Name (Legal Business Name): YAMIL CESAR RIVERA-COLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 10/01/2020
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 SAN RAFAEL APDO 11338
SAN JUAN PR
00910-3428
US

IV. Provider business mailing address

PO BOX 8550
SAN JUAN PR
00910-8550
US

V. Phone/Fax

Practice location:
  • Phone: 787-772-1007
  • Fax:
Mailing address:
  • Phone: 787-475-6271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number15294
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: