MEDICARE: JOSE J RIVERA ESPARRA 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
1	207R00000X	Internal Medicine Physician	14200	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14200	OTHER	PR	LICENCIA

General Provider Information

NPI Number	:	1356314652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSE J RIVERA ESPARRA MD

Provider Business Mailing Address
First Line	:	5005 CONSTANCIA URB HDAS DEL MONTE
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-0000
Country	:	US
Telephone Number	:	787-973-0010
Fax Number	:	787-842-3512

Provider Business Practice Location Address
First Line	:	623 AVE LA CEIBA
Second Line	:	ROVIRA OFFICE PARTK SUITE 403
City	:	PONCE
State	:	PR
Zip	:	00717-0000
Country	:	US
Telephone Number	:	787-973-0010
Fax Number	:	787-973-0011

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	05/16/2024

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Directions to “ JOSE J RIVERA ESPARRA MD” Practice Location

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