Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 12241 | PR |
Y | 208000000X | Pediatrician | 12241 | PR |
NPI | 1770543126 |
---|---|
Provider Name | Dr. Doris Rivera |
First Address | San Juan, PR 00922-1913 |
Second Address | San Juan, PR 00907-1511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 18/01/2019 |