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General NPI Number Information
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NPI Number | 1255307070
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Entity Type | Individual
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Provider Name | JOSE G RIVERA GUILBE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 04/17/2022
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Provider Practice Location Address
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Address Line | 30 CALLE FLORENCIO SANTIAGO
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City | COAMO
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State | PR
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Zip | 00769-3260
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Country | US
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Telephone | 787-803-4659
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Fax | 787-825-2296
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Provider Business Mailing Address
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Address Line | PO BOX 440 #30 FLORENCIO SANTIAGO
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City | COAMO
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State | PR
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Zip | 00769-0440
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Country | US
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Telephone | 787-825-2296
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Fax | 939-732-7072
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 11465
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License Number State | PR
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