Provider Demographics
NPI:1255307070
Name:RIVERA GUILBE, JOSE G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:G
Last Name:RIVERA GUILBE
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:#30 FLORENCIO SANTIAGO
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769-0440
Mailing Address - Country:US
Mailing Address - Phone:787-825-2296
Mailing Address - Fax:939-732-7072
Practice Address - Street 1:30 CALLE FLORENCIO SANTIAGO
Practice Address - Street 2:
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769-3260
Practice Address - Country:US
Practice Address - Phone:787-803-4659
Practice Address - Fax:787-825-2296
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR11465208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG46302Medicare UPIN