MEDICARE: DR. ANGEL EDUARDO RIVERA - BARRIOS 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	208600000X	Surgery Physician	18303	PR
2	2086S0122X	Plastic and Reconstructive Surgery Physician	18303	PR
3	208600000X	Surgery Physician	34566	SC

General Provider Information

NPI Number	:	1770782443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL EDUARDO RIVERA - BARRIOS M.D.

Provider Business Mailing Address
First Line	:	DEPARTAMENTO DE CIRUGIA RCM
Second Line	:	PO BOX 29134
City	:	SAN JUAN
State	:	PR
Zip	:	00929-0134
Country	:	US
Telephone Number	:	787-998-8539
Fax Number	:	787-740-3082

Provider Business Practice Location Address
First Line	:	CLINICA DE LA ESCUELA DE MEDICINA
Second Line	:	CENTRO COMERCIAL REPARTO METROPOLITANO
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00921-0000
Country	:	US
Telephone Number	:	787-998-8539
Fax Number	:	787-740-3082

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

Provider Enumeration Date	:	07/13/2007
Last Update Date	:	06/09/2016

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