Provider Demographics
NPI:1023399441
Name:RRB HEART & VASCULAR PHYSICIANS, PSC
Entity Type:Organization
Organization Name:RRB HEART & VASCULAR PHYSICIANS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:RIVERA BERRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-709-0791
Mailing Address - Street 1:PMB 374 AVE TITO CASTRO
Mailing Address - Street 2:STE 102
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716
Mailing Address - Country:US
Mailing Address - Phone:787-709-0791
Mailing Address - Fax:
Practice Address - Street 1:909 AVE TITO CASTRO
Practice Address - Street 2:TORRE MEDICA SAN LUCAS SUITE 504
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4728
Practice Address - Country:US
Practice Address - Phone:787-709-0791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16384207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRDJ458AMedicare PIN