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General NPI Number Information
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NPI Number | 1861305922
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Entity Type | Organization
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Legal Business Name | MD360 LLC
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 2225 PONCE BYP
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City | PONCE
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State | PR
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Zip | 00717-1321
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Country | US
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Telephone | 787-849-0956
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Fax | 787-812-0910
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Provider Business Mailing Address
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Address Line | 2919 CALLE GUILARTE
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City | PONCE
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State | PR
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Zip | 00716-4805
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Country | US
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Telephone | 787-717-2925
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LILLIAN VICTORIA RIVERA
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Credential | MD
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Telephone | 787-717-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | NULL
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