Provider Demographics
NPI:1528371770
Name:RIVERA-PEREZ, NICOLE IRENA
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:IRENA
Last Name:RIVERA-PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB SABANERA DORADO CAMINO TORRECILLA NUM 576
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00676-9998
Mailing Address - Country:US
Mailing Address - Phone:787-519-5692
Mailing Address - Fax:787-650-4246
Practice Address - Street 1:HOSPITAL WILMA VAZQUEZ CARR 2 K.M 39.5
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00676-9998
Practice Address - Country:US
Practice Address - Phone:787-519-5693
Practice Address - Fax:787-650-4246
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20558207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease