Basic Information
| Provider Information | |||||||||
| NPI: | 1780811331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RIVERA MARRERO | ||||||||
| FirstName: | KARINES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | URB SAN RAFAEL ESTATE | ||||||||
| Address2: | 224 C 26 CALLE LIRIO | ||||||||
| City: | BAYAMON | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009594294 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7876088783 | ||||||||
| FaxNumber: | 7878541452 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 AVE CONCEPCION VERA AYALA | ||||||||
| Address2: | |||||||||
| City: | MOCA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878773331 | ||||||||
| FaxNumber: | 7878773331 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2009 | ||||||||
| LastUpdateDate: | 07/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 18110 | PR | N | Allopathic & Osteopathic Physicians | General Practice | 207L00000X | 18110 | PR | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.