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General NPI Number Information
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NPI Number | 1467400804
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Entity Type | Individual
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Provider Name | CARMEN RIVERA PEREZ MD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 1902 CALLE LOIZA
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City | SAN JUAN
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State | PR
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Zip | 00911-1891
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Country | US
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Telephone | 787-616-7626
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Fax | 787-848-0318
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Provider Business Mailing Address
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Address Line | 603 CALLE HIPODROMO APT 1605 HIPODROMO 603
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City | SAN JUAN
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State | PR
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Zip | 00909-2146
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Country | US
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Telephone | 787-725-8484
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Fax | 787-848-0318
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 8539
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License Number State | PR
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