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General NPI Number Information
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NPI Number | 1508727017
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Entity Type | Individual
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Provider Name | JAIME LUIS RIVERA RIVERA ND
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Gender | Male
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | AH19 CALLE 23
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City | BAYAMON
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State | PR
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Zip | 00961-8347
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Country | US
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Telephone | 210-571-5660
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Fax |
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Provider Business Mailing Address
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Address Line | AH19 CALLE 23
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City | BAYAMON
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State | PR
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Zip | 00961-8347
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Country | US
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Telephone | 210-571-5660
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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 | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number | 119
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License Number State | PR
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