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General NPI Number Information
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NPI Number | 1396610325
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Entity Type | Organization
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Legal Business Name | RIVERA MIRABAL UROLOGY LLC
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | SAN JORGE MEDICAL OFFICE BUILDING SUITE 401 SAN JORGE STREET 252
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City | SAN JUAN
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State | PR
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Zip | 00912-0000
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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 BUILDING SUITE 401 SAN JORGE STREET 252
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City | SAN JUAN
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State | PR
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Zip | 00912-0000
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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 | PRESIDENT
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Name | DR. JORGE L RIVERA MIRABAL
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Credential | M.D.
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Telephone | 787-726-1484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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