Provider Demographics
NPI:1619963113
Name:RIVERA GONZALEZ, HECTOR O (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:O
Last Name:RIVERA GONZALEZ
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 2020
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-2020
Mailing Address - Country:US
Mailing Address - Phone:787-263-3333
Mailing Address - Fax:787-263-6363
Practice Address - Street 1:174 CALLE LUIS BARRERAS S
Practice Address - Street 2:HOSPITAL MUNICIPAL DE AREA
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4615
Practice Address - Country:US
Practice Address - Phone:787-263-3333
Practice Address - Fax:787-263-6363
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR62392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79635Medicare UPIN
PR0027201Medicare ID - Type Unspecified