MEDICARE: KARY MICHELLE BOUET-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	2080N0001X	Neonatal-Perinatal Medicine Physician	17581	PR
2	208000000X	Pediatrics Physician	11413	PR

General Provider Information

NPI Number	:	1437358397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARY MICHELLE BOUET-RIVERA M.D.

Provider Business Mailing Address
First Line	:	3 STREET S 315
Second Line	:	VILLAS DE PARANA
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-753-6390
Fax Number	:

Provider Business Practice Location Address
First Line	:	S3-15 CALLE 3
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6047
Country	:	US
Telephone Number	:	178-777-5555
Fax Number	:

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

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	02/14/2025

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