Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 16384 | PR |
N | 111NI0900X | Internist | 16384 | PR |
N | 207RC0000X | Internist - Cardiovascular Disease | 16384 | PR |
Y | 207RI0011X | Interventional Cardiology | 16384 | PR |
NPI | 1003911264 |
---|---|
Provider Name | Rafael Jose Rivera |
First Address | Ponce, PR 00716 |
Second Address | Ponce, PR 00716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 12/05/2017 |