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NPI Code Detail

MEDICARE: DR. JOSE AMADO MAYMI RIVERA M.D.

MEDICARE: DR. JOSE AMADO MAYMI RIVERA M.D.
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
1208800000XUrology Physician7681PR
2174400000XSpecialist7681PR

General Provider Information

NPI Number : 1124085790
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSE AMADO MAYMI RIVERA M.D.
Provider Business Mailing Address
First Line : 100 PASEO SAN PABLO STE 410
Second Line :
City : BAYAMON
State : PR
Zip : 00961-7028
Country : US
Telephone Number : 787-780-0970
Fax Number : 787-780-5042
Provider Business Practice Location Address
First Line : 100 PASEO SAN PABLO STE 410
Second Line :
City : BAYAMON
State : PR
Zip : 00961-7028
Country : US
Telephone Number : 787-780-0970
Fax Number : 787-780-5240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 04/11/2020

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