MEDICARE: DR. MANUEL A RIVERO ITURREGUI 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	11419	PR

General Provider Information

NPI Number	:	1861477580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANUEL A RIVERO ITURREGUI MD

Provider Business Mailing Address
First Line	:	1760 CALLE LOIZA
Second Line	:	SUITE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1801
Country	:	US
Telephone Number	:	787-726-5486
Fax Number	:	787-728-6031

Provider Business Practice Location Address
First Line	:	1760 CALLE LOIZA
Second Line	:	SUITE 203
City	:	SAN JUAN
State	:	PR
Zip	:	00911-1801
Country	:	US
Telephone Number	:	787-726-5486
Fax Number	:	787-728-6031

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	02/27/2019

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