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General NPI Number Information
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NPI Number | 1740247907
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Entity Type | Individual
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Provider Name | JOSE LUIS RIVERA-PIETRI MD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | NUMBER 2 ANA D PEREZ MARCHAND ST INDUSTRIAL REPARADA
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City | PONCE
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State | PR
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Zip | 00715
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Country | US
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Telephone | 787-840-0052
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7456 PAMPANOS STATION
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City | PONCE
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State | PR
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Zip | 00732-7456
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Country | US
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Telephone | 787-843-4045
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Fax | 787-812-5677
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4426
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License Number State | PR
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