Provider Demographics
NPI:1205011434
Name:RIVERA- FROMETA, BETH ANN (MD)
Entity Type:Individual
Prefix:
First Name:BETH ANN
Middle Name:
Last Name:RIVERA- FROMETA
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:PO BOX 2045
Mailing Address - Street 2:
Mailing Address - City:BARCELONETA
Mailing Address - State:PR
Mailing Address - Zip Code:00617-2045
Mailing Address - Country:US
Mailing Address - Phone:787-846-4412
Mailing Address - Fax:
Practice Address - Street 1:CARR NO 2 KM 57 8
Practice Address - Street 2:CRUCE DAVILA
Practice Address - City:BARCELONETA
Practice Address - State:PR
Practice Address - Zip Code:00617-0061
Practice Address - Country:US
Practice Address - Phone:787-846-4412
Practice Address - Fax:787-846-7410
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16852208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice