Provider Demographics
NPI:1639216146
Name:PEREZ-RIVAS, JOSE F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:F
Last Name:PEREZ-RIVAS
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 1:1201 N.W. 16TH ST. MIAMI VA MEDICAL CENTER
Mailing Address - Street 2:C&P
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125
Mailing Address - Country:US
Mailing Address - Phone:305-324-4455
Mailing Address - Fax:787-200-4352
Practice Address - Street 1:1201 N.W. 16TH ST.
Practice Address - Street 2:C&P
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-324-4455
Practice Address - Fax:787-200-4352
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4609207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77347Medicare UPIN
PR25589Medicare ID - Type Unspecified