Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18396 | PR |
N | 111NI0900X | Internist | 18396 | PR |
N | 207R00000X | Internist | ME128230 | FL |
N | 111NI0900X | Internist | ME128230 | FL |
Y | 207RC0000X | Internist - Cardiovascular Disease | ME128230 | FL |
NPI | 1013165141 |
---|---|
Provider Name | Dr. Jose David Rivera-Jimenez |
First Address | Sebastian, FL 32958-3427 |
Second Address | Sebastian, FL 32958-3427 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2008 |
Last Update Date | 29/07/2016 |