MEDICARE: DR. FERDINAND RIVERA ORTIZ 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	207RN0300X	Nephrology Physician	13326	PR

General Provider Information

NPI Number	:	1174554356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FERDINAND RIVERA ORTIZ M.D.

Provider Business Mailing Address
First Line	:	COND HATO REY CENTRO APT T-101
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-5254
Country	:	US
Telephone Number	:	787-359-2516
Fax Number	:	787-762-3120

Provider Business Practice Location Address
First Line	:	130 AVE ARTERIAL HOSTOS APT T101
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-5254
Country	:	US
Telephone Number	:	787-359-2516
Fax Number	:	787-762-3120

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/08/2007

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