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General NPI Number Information
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NPI Number | 1366431660
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Entity Type | Individual
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Provider Name | MILAGROS RIVERA MD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 11/28/2016
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Provider Practice Location Address
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Address Line | 102 BRYAN WOODS ROAD
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City | SAVANNAH
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State | GA
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Zip | 31410
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Country | US
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Telephone | 912-898-1122
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Fax | 912-898-9944
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Provider Business Mailing Address
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Address Line | 602 E 72ND ST
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City | SAVANNAH
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State | GA
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Zip | 31405-4913
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Country | US
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Telephone | 912-819-7878
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Fax | 912-819-7850
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33755
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License Number State | KY
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