Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 8860 | PR |
NPI | 1033129473 |
---|---|
Provider Name | Dr. Victor Manuel Rivera |
First Address | Caguas, PR 00726-1570 |
Second Address | Caguas, PR 00725-2607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D34260 | (02) | PR |