Provider Demographics
NPI:1134699622
Name:RIVERA LEON, GABRIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:
Last Name:RIVERA LEON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE ALMONTE, TORRES DE ANDALUCIA T-1
Mailing Address - Street 2:APT.1402
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-640-2755
Mailing Address - Fax:
Practice Address - Street 1:CALLE ALMONTE, TORRES DE ANDALUCIA T-1
Practice Address - Street 2:APT.1402
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-640-2755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR656111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor