MEDICARE: DR. JUAN JOSE RIVERA TORRES 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207R00000X	Internal Medicine Physician	022302	PR

General Provider Information

NPI Number	:	1598212136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN JOSE RIVERA TORRES MD

Provider Business Mailing Address
First Line	:	361 CALLE GALILEO
Second Line	:	COND JARDINES METROPOLITANOS 2, APT 8K
City	:	SAN JUAN
State	:	PR
Zip	:	00927
Country	:	US
Telephone Number	:	787-615-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	COND PLZ
Second Line	:	200 CALLE ALCALA APT 1602 B
City	:	SAN JUAN
State	:	PR
Zip	:	00907-4442
Country	:	US
Telephone Number	:	787-615-4292
Fax Number	:

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

Provider Enumeration Date	:	09/01/2016
Last Update Date	:	03/10/2022

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