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General NPI Number Information
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NPI Number | 1124430467
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Entity Type | Organization
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Legal Business Name | DRA VALENIE RIVERA ROIG PSC
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 05/21/2014
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Provider Practice Location Address
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Address Line | 909 AVE TITO CASTRO STE 804 TORRE MEDICA SAN LUCAS
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City | PONCE
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State | PR
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Zip | 00716-4725
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Country | US
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Telephone | 787-648-8115
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Fax | 787-651-1498
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Provider Business Mailing Address
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Address Line | 909 AVE TITO CASTRO STE 804 TORRE MEDICA SAN LUCAS
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City | PONCE
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State | PR
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Zip | 00716-4725
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Country | US
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Telephone | 787-648-8115
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Fax | 787-651-1498
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VALENIE RIVERA ROIG
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Credential | MD
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Telephone | 787-648-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 14868
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License Number State | PR
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