Provider Demographics
NPI:1558345181
Name:SANDOZ RIVERA, ANIBAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIBAL
Middle Name:
Last Name:SANDOZ RIVERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:CASA 6
Mailing Address - Street 2:ROOSEVELT GARDENS
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735-0001
Mailing Address - Country:US
Mailing Address - Phone:787-206-1072
Mailing Address - Fax:787-251-4518
Practice Address - Street 1:ADMINISTRACION DE SERVICIOS MEDICOS DE PR
Practice Address - Street 2:BOX 2129
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-251-4518
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-06
Last Update Date:2011-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR13325208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH83481Medicare UPIN