Provider Demographics
NPI:1235255225
Name:RIVERVIEW MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:RIVERVIEW MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENTE
Authorized Official - Prefix:DR
Authorized Official - First Name:SURILO
Authorized Official - Middle Name:I
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-785-2694
Mailing Address - Street 1:PO BOX 51526
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00950-1526
Mailing Address - Country:US
Mailing Address - Phone:787-785-2694
Mailing Address - Fax:787-787-3109
Practice Address - Street 1:ZA1 CALLE 36
Practice Address - Street 2:URB. RIVERVIEW
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3929
Practice Address - Country:US
Practice Address - Phone:787-785-2694
Practice Address - Fax:787-787-3109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty