MEDICARE: DR. MARIA S. CORREA-RIVAS 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	10775	PR
2	207ZP0213X	Pediatric Pathology Physician	10775	PR

General Provider Information

NPI Number	:	1881666246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA S. CORREA-RIVAS MD

Provider Business Mailing Address
First Line	:	PO BOX 366481
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-6481
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:	787-754-0710

Provider Business Practice Location Address
First Line	:	UNIVERSIDAD DE PUERTO RICO , SCHOOL OF MEDICINE
Second Line	:	MEDICAL SCIENCES CAMPUS OFFICE 394
City	:	SAN JUAN
State	:	PR
Zip	:	00921-6481
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:	787-754-0710

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	03/20/2013

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