Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 12244 | PR |
NPI | 1003934589 |
---|---|
Provider Name | Dr. Ana I Rivera De La Vega |
First Address | San Juan, PR 00926 |
Second Address | Bayamon, PR 00961-7019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 14/03/2012 |