Provider Demographics
NPI:1144808841
Name:RIVERA, CARLOS FRANCISCO
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:FRANCISCO
Last Name:RIVERA
Suffix:
Gender:M
Credentials:
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 51255
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1255
Mailing Address - Country:US
Mailing Address - Phone:787-347-7755
Mailing Address - Fax:
Practice Address - Street 1:MAR DEL NORTE 688
Practice Address - Street 2:CORALES 2, PASEOS DE DORADO
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-796-8414
Practice Address - Fax:787-333-6799
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service