Healthcare Provider Details

I. General information

NPI: 1801846274
Provider Name (Legal Business Name): JULIO CESAR RIVERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 SAN JORGE STREET CHILDRENS HOSPITAL
SANTURCE PR
00912
US

IV. Provider business mailing address

PO BOX 79852
CAROLINA PR
00984-9852
US

V. Phone/Fax

Practice location:
  • Phone: 787-727-5555
  • Fax:
Mailing address:
  • Phone: 787-791-6565
  • Fax: 787-791-6565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1739041
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number11619
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: