Provider Demographics
NPI:1669034161
Name:RIVERA SILVA, GLORIANA (MD)
Entity Type:Individual
Prefix:
First Name:GLORIANA
Middle Name:
Last Name:RIVERA SILVA
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 1:190 CALLE JOSE PARES
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-2224
Mailing Address - Country:US
Mailing Address - Phone:787-222-0350
Mailing Address - Fax:
Practice Address - Street 1:190 CALLE JOSE PARES
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-2224
Practice Address - Country:US
Practice Address - Phone:787-222-0350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15078-I208D00000X
PR21776208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice