Provider Demographics
NPI:1215193735
Name:RIVERA ROSADO, MIREILY (MD)
Entity Type:Individual
Prefix:
First Name:MIREILY
Middle Name:
Last Name:RIVERA ROSADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIREILY
Other - Middle Name:
Other - Last Name:RIVERA ROSADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 362713
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2713
Mailing Address - Country:US
Mailing Address - Phone:787-955-6292
Mailing Address - Fax:
Practice Address - Street 1:CARIMED PLZ STE 505B-1
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6928
Practice Address - Country:US
Practice Address - Phone:787-955-6292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17965207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology