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General NPI Number Information
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NPI Number | 1144324690
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Entity Type | Individual
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Provider Name | MIGUEL ANGEL RIVERA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 41 CALLE SANTA CRUZ
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-778-2800
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Fax | 787-273-7509
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Provider Business Mailing Address
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Address Line | L-1B CALLE BAMBOO DR TORRIMAR ALTO
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City | GUAYNABO
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State | PR
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Zip | 00966-3143
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Country | US
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Telephone | 787-413-0474
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Fax | 787-273-7509
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 10508
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License Number State | PR
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