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General NPI Number Information
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NPI Number | 1437358397
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Entity Type | Individual
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Provider Name | KARY MICHELLE BOUET-RIVERA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/12/2007
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | S3-15 CALLE 3
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City | SAN JUAN
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State | PR
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Zip | 00926-6047
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Country | US
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Telephone | 178-777-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 3 STREET S 315 VILLAS DE PARANA
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-753-6390
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 17581
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 11413
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License Number State | PR
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