Provider Demographics
NPI:1235411463
Name:RIVERA RAMOS, CRISTOBAL (M D)
Entity Type:Individual
Prefix:
First Name:CRISTOBAL
Middle Name:
Last Name:RIVERA RAMOS
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VILLA DEL SOL
Mailing Address - Street 2:A-8
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PLZ SANTA ISABEL
Practice Address - Street 2:#15
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-4002
Practice Address - Country:US
Practice Address - Phone:787-929-5882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28436-R207R00000X
PR19,011207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine