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General NPI Number Information
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NPI Number | 1285283317
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Entity Type | Individual
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Provider Name | ROBERT RIVERA MD
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Gender | Male
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Dates
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Enumeration Date | 09/11/2019
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | CARR. PR 173, KM 6, HM5, SECTOR SAN JOSE, BO. RABANAL
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-520-7390
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Fax | 787-520-7108
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Provider Business Mailing Address
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Address Line | P.O. BOX 459
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-520-7390
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Fax | 787-520-7108
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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 | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number | 9611
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License Number State | PR
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