Provider Demographics
NPI:1457470213
Name:RIVERA LUNA, HIRAM (MD)
Entity Type:Individual
Prefix:
First Name:HIRAM
Middle Name:
Last Name:RIVERA LUNA
Suffix:
Gender:M
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 6960
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6960
Mailing Address - Country:US
Mailing Address - Phone:787-744-5278
Mailing Address - Fax:787-744-5433
Practice Address - Street 1:CONSOLIDATED MEDICAL PLAZA SUITE 101
Practice Address - Street 2:201 AVE GAUTIER BENITEZ
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-5278
Practice Address - Fax:787-744-5433
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9549207R00000X, 207U00000X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound