Provider Demographics
NPI:1598212136
Name:RIVERA TORRES, JUAN JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:JOSE
Last Name:RIVERA TORRES
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 1:361 CALLE GALILEO
Mailing Address - Street 2:COND JARDINES METROPOLITANOS 2, APT 8K
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-615-4292
Mailing Address - Fax:
Practice Address - Street 1:COND PLZ
Practice Address - Street 2:200 CALLE ALCALA APT 1602 B
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-4442
Practice Address - Country:US
Practice Address - Phone:787-615-4292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR022302207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program