Provider Demographics
NPI:1760922728
Name:RIVERA RIOS, JEANEISHKA MARIE (MD)
Entity type:Individual
Prefix:
First Name:JEANEISHKA
Middle Name:MARIE
Last Name:RIVERA RIOS
Suffix:
Gender:F
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:URB PRADERA NORTE
Mailing Address - Street 2:AX 2 CALLE 1
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3693
Mailing Address - Country:US
Mailing Address - Phone:787-795-5843
Mailing Address - Fax:
Practice Address - Street 1:URB PRADERA NORTE
Practice Address - Street 2:AX2 CALLE 1
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-3693
Practice Address - Country:US
Practice Address - Phone:787-795-5843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23315207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine