1144808841 NPI number — CARLOS FRANCISCO RIVERA

Table of content: CARLOS FRANCISCO RIVERA (NPI 1144808841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144808841 NPI number — CARLOS FRANCISCO RIVERA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA
Provider First Name:
CARLOS
Provider Middle Name:
FRANCISCO
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1144808841
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 51255
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00950-1255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-347-7755
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MAR DEL NORTE 688
Provider Second Line Business Practice Location Address:
CORALES 2, PASEOS DE DORADO
Provider Business Practice Location Address City Name:
DORADO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-796-8414
Provider Business Practice Location Address Fax Number:
787-333-6799
Provider Enumeration Date:
04/01/2021

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: 305S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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