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NPI Code Detail

MEDICARE: ROSBEL GONZALEZ RIVERA MD

MEDICARE: ROSBEL GONZALEZ RIVERA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician19553PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
119553OTHERPRLICENSE

General Provider Information

NPI Number : 1003124728
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSBEL GONZALEZ RIVERA MD
Provider Business Mailing Address
First Line : PO BOX 366842
Second Line :
City : SAN JUAN
State : PR
Zip : 00936-6842
Country : US
Telephone Number : 787-798-1200
Fax Number :
Provider Business Practice Location Address
First Line : 68 CALLE SANTA CRUZ STE 305 TORRE SAN PABLO
Second Line :
City : BAYAMON
State : PR
Zip : 00961-7036
Country : US
Telephone Number : 787-798-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2010
Last Update Date : 08/09/2024

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