Provider Demographics
NPI:1386676690
Name:BAEZ RIVERA, EMILIO A (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILIO
Middle Name:A
Last Name:BAEZ RIVERA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4952
Mailing Address - Street 2:PMB 580
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4952
Mailing Address - Country:US
Mailing Address - Phone:787-258-2237
Mailing Address - Fax:787-747-0964
Practice Address - Street 1:81 AVE LUIS MUNOZ MARIN STE 201
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-3883
Practice Address - Country:US
Practice Address - Phone:787-258-2237
Practice Address - Fax:787-747-0964
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13195207W00000X
PR013195207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0085403AMedicare PIN
PR660652144Medicare PIN