MEDICARE: NOMA VISION CSP

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	207WX0009X	Glaucoma Specialist (Ophthalmology) Physician

General Provider Information

NPI Number	:	1659957496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOMA VISION CSP

Provider Business Mailing Address
First Line	:	PO BOX 1176
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00726-1176
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CALLE MUNOZ RIVERA STE 201
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725-2605
Country	:	US
Telephone Number	:	787-319-7395
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ENRIQUE J RIVERA
Credential	:	MD
Telephone Number	:	787-319-7395

Provider Enumeration Date	:	03/22/2021
Last Update Date	:	01/19/2026

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