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General NPI Number Information
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NPI Number | 1619226578
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Entity Type | Individual
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Provider Name | KELVIN XAVIER RIVERA MANZANO M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2012
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | SAN JUAN CITY HOSPITAL PMB # 79
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City | SAN JAUN
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State | PR
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Zip | 00936
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Country | US
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Telephone | 787-480-2700
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Fax |
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Provider Business Mailing Address
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Address Line | MADRIGAL 194 URB. LA SERRANIA
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City | CAGUAS
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State | PR
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Zip | 00725
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Country | US
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Telephone | 787-360-3945
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 19015
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 19015
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 19015
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License Number State | PR
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