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NPI Code Detail

MEDICARE: DR. ROBERT RIVERA

MEDICARE: DR. ROBERT RIVERA
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
12085R0202XDiagnostic Radiology Physician13098PR

General Provider Information

NPI Number : 1063406536
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT RIVERA
Provider Business Mailing Address
First Line : PO BOX 602727
Second Line :
City : BAYAMON
State : PR
Zip : 00960-6037
Country : US
Telephone Number : 787-780-9069
Fax Number : 787-780-2121
Provider Business Practice Location Address
First Line : 1815 ROAD # 2 KM 11.7
Second Line : CT RADIOLOGY COMPLEX BLDG
City : BAYAMON
State : PR
Zip : 00959-7279
Country : US
Telephone Number : 787-780-9069
Fax Number : 787-780-2121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 03/30/2010

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Directions to “ DR. ROBERT RIVERA ” Practice Location

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