Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 21218 | PR |
N | 208D00000X | General Practice Physician | 13538-I | PR |
NPI | 1043626278 |
---|---|
Provider Name | Juan Carlos Alvarez Rivera |
First Address | Ponce, PR 00717-0642 |
Second Address | Ponce, PR 00717-0642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2014 |
Last Update Date | 19/11/2019 |