Basic Information
| Provider Information | |||||||||
| NPI: | 1285899260 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIVERA | ||||||||
| FirstName: | JOSE | ||||||||
| MiddleName: | ORLANDO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3504 | ||||||||
| Address2: | |||||||||
| City: | JUNCOS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007776504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875351001 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CARR 14 | ||||||||
| Address2: | BO RINCON SECT LOMAS | ||||||||
| City: | CAYEY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007363717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872077900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2008 | ||||||||
| LastUpdateDate: | 03/04/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 17244 | PR | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.