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General NPI Number Information
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NPI Number | 1700307238
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Entity Type | Individual
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Provider Name | EDUARDO RENE RIVERA MIRABAL MD
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Gender | Male
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 7900 LITTLE RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34654-5405
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Country | US
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Telephone | 727-869-4100
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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 401 252 SAN JORGE STREET
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City | SAN JUAN
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State | PR
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Zip | 00912
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Country | US
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Telephone | 787-990-4900
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Fax | 840-400-4826
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME158690
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 24505
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 319312
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | T3862
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License Number State | TX
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