MEDICARE: AUREA A 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	14125	PR

General Provider Information

NPI Number	:	1770573271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUREA A RIVERA M.D.

Provider Business Mailing Address
First Line	:	URB SAN AGUSTIN
Second Line	:	CALLE RAFAEL CASTILLO #1153
City	:	SAN JUAN
State	:	PR
Zip	:	00923
Country	:	US
Telephone Number	:	787-753-3973
Fax Number	:	787-268-3792

Provider Business Practice Location Address
First Line	:	SAN JUAN HEALTH CENTRE
Second Line	:	SUITE 503, SANTURCE
City	:	SAN JUAN
State	:	PR
Zip	:	00907
Country	:	US
Telephone Number	:	787-725-7348
Fax Number	:	787-725-5025

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/09/2007

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