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General NPI Number Information
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NPI Number | 1295254290
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Entity Type | Individual
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Provider Name | NELITZA IVEMARIS RIVERA VEGA
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Gender | Female
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | SAN JORGE MEDICAL OFFICE BLDG SUITE 401 252 SAN JORGE ST.
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-726-1484
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Fax |
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Provider Business Mailing Address
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Address Line | SAN JORGE MEDICAL OFFICE BLDG. SUITE 401 252 SAN JORGE ST.
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-726-1484
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | BP1006738
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 24468
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 321902
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME167900
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License Number State | FL
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