1598212136 NPI number — DR. JUAN JOSE RIVERA TORRES MD

Table of content: DR. JUAN JOSE RIVERA TORRES MD (NPI 1598212136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598212136 NPI number — DR. JUAN JOSE RIVERA TORRES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA TORRES
Provider First Name:
JUAN
Provider Middle Name:
JOSE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1598212136
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
361 CALLE GALILEO
Provider Second Line Business Mailing Address:
COND JARDINES METROPOLITANOS 2, APT 8K
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-615-4292
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
COND PLZ
Provider Second Line Business Practice Location Address:
200 CALLE ALCALA APT 1602 B
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-4442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-615-4292
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/01/2016

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 022302 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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