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General NPI Number Information
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NPI Number | 1841768256
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Entity Type | Individual
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Provider Name | JHONATAN DANIEL RIVERA MORA MD
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Gender | Male
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Dates
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Enumeration Date | 11/05/2018
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | UTMB GME 301 UNIVERSITY BLVD 5.138 RS
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City | GALVESTON
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State | TX
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Zip | 77555-1001
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Country | US
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Telephone | 409-772-2222
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Fax |
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Provider Business Mailing Address
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Address Line | HC 4 BOX 40410
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City | MAYAGUEZ
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State | PR
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Zip | 00680-9406
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Country | US
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Telephone | 787-757-1800
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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 | TRN#33897
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | BP10089916
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License Number State | TX
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