Provider Demographics
NPI:1033104179
Name:VARGAS-RIVERA, LYMARI (MD)
Entity Type:Individual
Prefix:DR
First Name:LYMARI
Middle Name:
Last Name:VARGAS-RIVERA
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:PMB 854 WINSTON CHURCILL
Mailing Address - Street 2:URB CROWN HILLS 138
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0613
Mailing Address - Country:US
Mailing Address - Phone:787-407-1615
Mailing Address - Fax:787-759-0101
Practice Address - Street 1:550 CALLE SERGIO CUEVAS
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2683
Practice Address - Country:US
Practice Address - Phone:787-407-1615
Practice Address - Fax:787-759-0101
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-14
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15740207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRCU841AMedicare PIN