Provider Demographics
NPI:1376962118
Name:RIVERA BUSCAGLIA, ANNABELLE (MD, DC)
Entity Type:Individual
Prefix:
First Name:ANNABELLE
Middle Name:
Last Name:RIVERA BUSCAGLIA
Suffix:
Gender:F
Credentials:MD, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CALLE WASHINGTON
Mailing Address - Street 2:COND. CONDADO PRINCESS APT 104
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-1591
Mailing Address - Country:US
Mailing Address - Phone:787-379-7650
Mailing Address - Fax:
Practice Address - Street 1:1768 CALLE GLASGOW
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-4810
Practice Address - Country:US
Practice Address - Phone:787-379-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-09
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR570111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1902266968OtherCHIRO CARE PUERTO RICO