Provider Demographics
NPI:1255316618
Name:RIVERA BARBOSA, MARGARITA (MD)
Entity Type:Individual
Prefix:MISS
First Name:MARGARITA
Middle Name:
Last Name:RIVERA BARBOSA
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 7999
Mailing Address - Street 2:PMB 352
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7999
Mailing Address - Country:US
Mailing Address - Phone:787-805-2390
Mailing Address - Fax:787-805-1949
Practice Address - Street 1:CALLE DE DIEGO 55 ESTE
Practice Address - Street 2:CPR PROFESSIONAL BUILDING SUITE202
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-5080
Practice Address - Country:US
Practice Address - Phone:787-805-2390
Practice Address - Fax:787-805-1949
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13019208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0020285Medicare ID - Type Unspecified
PRH82800Medicare UPIN