1205879004 NPI number — DR. JUANA I. RIVERA-VINAS MD, MHSA,

Table of content: DR. JUANA I. RIVERA-VINAS MD, MHSA, (NPI 1205879004)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205879004 NPI number — DR. JUANA I. RIVERA-VINAS MD, MHSA,

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
RIVERA-VINAS

Provider First Name:
JUANA

Provider Middle Name:
I.

Provider Name Prefix Text:
DR.

Provider Name Suffix Text:

Provider Credential Text:
MD, MHSA,

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205879004

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
03/14/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
OB & GYN RCM

Provider Second Line Business Mailing Address:
PO BOX 29134

Provider Business Mailing Address City Name:
SAN JUAN

Provider Business Mailing Address State Name:
PR

Provider Business Mailing Address Postal Code:
00929-0134

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
787-756-0049

Provider Business Mailing Address Fax Number:
787-764-7881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HOSPITAL UNIVERSITARIO DE ADULTOS MIC

Provider Second Line Business Practice Location Address:
CENTRO MEDICO DE PUERTO RICO

Provider Business Practice Location Address City Name:
RIO PIEDRAS

Provider Business Practice Location Address State Name:
PR

Provider Business Practice Location Address Postal Code:
00935

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
787-756-0049

Provider Business Practice Location Address Fax Number:
787-764-7881

Provider Enumeration Date:
06/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 207V00000X , with the licence number: 8812 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .