MEDICARE: DR. NELSON RIVERA 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	207R00000X	Internal Medicine Physician	8828	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	28828	OTHER		MCS
2	200110	OTHER	PR	MMM
3	061249	OTHER		CRUZ AZUL
4	88860RI	OTHER		SSS
5	0432	OTHER	PR	IMC
6	7660024	OTHER		HUMANA

General Provider Information

NPI Number	:	1700875861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NELSON RIVERA RIVERA M.D.

Provider Business Mailing Address
First Line	:	1 CALLE FIGUEROA
Second Line	:
City	:	VILLALBA
State	:	PR
Zip	:	00766-2226
Country	:	US
Telephone Number	:	178-784-7777
Fax Number	:	178-784-7777

Provider Business Practice Location Address
First Line	:	1 CALLE FIGUEROA
Second Line	:
City	:	VILLALBA
State	:	PR
Zip	:	00766-2226
Country	:	US
Telephone Number	:	178-784-7777
Fax Number	:	178-784-7777

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

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	04/14/2020

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Directions to “ DR. NELSON RIVERA RIVERA M.D.” Practice Location

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