Provider Demographics
NPI:1689642134
Name:RIVERA RIOS, EUGENIO (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:
Last Name:RIVERA RIOS
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 7776
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732
Mailing Address - Country:US
Mailing Address - Phone:787-840-2160
Mailing Address - Fax:787-840-2104
Practice Address - Street 1:2431 AVENIDA LAS AMERICAS
Practice Address - Street 2:PORRATA PILA SUITE 300
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-840-2160
Practice Address - Fax:787-840-2104
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6205207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028077AMedicare PIN
D08747Medicare UPIN