Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 5983 | PR |
NPI | 1649353152 |
---|---|
Provider Name | Dr. Javier A Rivera |
First Address | Orocovis, PR 00720-1475 |
Second Address | Orocovis, PR 00720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E66285 | (02) | PR |