Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 7397 | PR |
NPI | 1023060563 |
---|---|
Provider Name | Dr. Hector R Cordova-Rivera |
First Address | Guaynabo, PR 00968-3100 |
Second Address | San Juan, PR 00921-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 05/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7397 | MEDICAL LICENSE NUMBER (01) | PR |