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General NPI Number Information
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NPI Number | 1205516366
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Entity Type | Organization
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Legal Business Name | EMERGE PBC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 869 AVE MUNOZ RIVERA STE 303
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City | SAN JUAN
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State | PR
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Zip | 00925-2103
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Country | US
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Telephone | 939-330-1109
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Fax | 866-379-9205
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Provider Business Mailing Address
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Address Line | PO BOX 70344
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City | SAN JUAN
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State | PR
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Zip | 00936-8344
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Country | US
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Telephone | 939-330-1109
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Fax | 866-379-9205
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIBEL CAMPOS RIVERA
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Credential | MD MSC MBA
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Telephone | 787-436-8857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080B0002X
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Taxonomy Name | Pediatric Obesity Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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