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General NPI Number Information
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NPI Number | 1700849817
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Entity Type | Individual
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Provider Name | CARLOS GILBERTO RIVERA BERMUDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 313 AVE DOMENECH BALDRICH
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City | SAN JUAN
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State | PR
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Zip | 00918-3532
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Country | US
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Telephone | 787-763-7423
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Fax | 787-763-2039
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Provider Business Mailing Address
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Address Line | 113 CALLE ALHELI, URB. SAN FRANCISCO
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City | SAN JUAN
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State | PR
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Zip | 00927
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Country | US
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Telephone | 787-758-6857
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Fax | 787-764-9178
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 4441
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License Number State | PR
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