MEDICARE: DR. ALEJANDRO ANIBAL 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
1	208D00000X	General Practice Physician	17865	PR

General Provider Information

NPI Number	:	1154633659
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEJANDRO ANIBAL RIVERA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 800306
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-0306
Country	:	US
Telephone Number	:	787-315-0306
Fax Number	:

Provider Business Practice Location Address
First Line	:	HOSPITAL SAN CRISTOBAL CARR. 506
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-0501
Country	:	US
Telephone Number	:	787-315-0306
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2010
Last Update Date	:	09/04/2012

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