Provider Demographics
NPI:1629294137
Name:RIVERA, ADA I (MD)
Entity Type:Individual
Prefix:DR
First Name:ADA
Middle Name:I
Last Name:RIVERA
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Gender:F
Credentials:MD
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Mailing Address - Street 1:220 AVE DOMENECH
Mailing Address - Street 2:PMB 233
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3533
Mailing Address - Country:US
Mailing Address - Phone:787-787-9481
Mailing Address - Fax:787-787-9533
Practice Address - Street 1:ST CRUZ STREET #68
Practice Address - Street 2:TORRE SAN PABLO SUITE 403
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-787-9481
Practice Address - Fax:787-787-9533
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR16618207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology