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General NPI Number Information
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NPI Number | 1003934589
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Entity Type | Individual
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Provider Name | ANA I RIVERA DE LA VEGA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 100 PASEO SAN PABLO EDIF. DR. ARTURO CADILLA, SUITE 201
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City | BAYAMON
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State | PR
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Zip | 00961-7019
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Country | US
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Telephone | 787-778-8774
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Fax | 787-269-6190
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Provider Business Mailing Address
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Address Line | 100 GRAN BULEVAR PASEOS SUITE 112-272
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-755-5321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 12244
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License Number State | PR
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