Provider Demographics
NPI:1144298696
Name:RIVERA-PEREZ, CARLOS E (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:RIVERA-PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7065
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-7065
Mailing Address - Country:US
Mailing Address - Phone:787-841-1949
Mailing Address - Fax:787-812-0565
Practice Address - Street 1:1326 CALLE SALUD
Practice Address - Street 2:SUITE 413 SALUD 1326 ST
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1686
Practice Address - Country:US
Practice Address - Phone:787-841-1949
Practice Address - Fax:787-812-0565
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4160207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD08665Medicare UPIN
PR0028083Medicare ID - Type Unspecified