Provider Demographics
NPI:1568610459
Name:RIVERA-VEGA, ALEXANDRA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:M
Last Name:RIVERA-VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PRADERAS DEL PLATA
Mailing Address - Street 2:CALLE DESFILADERO SOLAR #5
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-3159
Mailing Address - Country:US
Mailing Address - Phone:787-635-2196
Mailing Address - Fax:
Practice Address - Street 1:7 PRADERAS DEL PLATA
Practice Address - Street 2:CALLE DESFILADERO SOLAR #5
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-3159
Practice Address - Country:US
Practice Address - Phone:787-635-2196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17934208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation