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General NPI Number Information
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NPI Number | 1023399441
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Entity Type | Organization
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Legal Business Name | RRB HEART & VASCULAR PHYSICIANS, PSC
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Dates
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Enumeration Date | 08/30/2011
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 909 AVE TITO CASTRO TORRE MEDICA SAN LUCAS SUITE 504
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City | PONCE
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State | PR
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Zip | 00716-4728
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Country | US
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Telephone | 787-709-0791
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 374 AVE TITO CASTRO STE 102
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City | PONCE
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State | PR
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Zip | 00716
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Country | US
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Telephone | 787-709-0791
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAFAEL J RIVERA BERRIOS
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Credential | MD
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Telephone | 787-709-0791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 16384
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License Number State | PR
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