Provider Demographics
NPI:1760133201
Name:MARIN-RIVERA, ANIBAL MIGUEL (MD)
Entity Type:Individual
Prefix:
First Name:ANIBAL
Middle Name:MIGUEL
Last Name:MARIN-RIVERA
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 6666
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6666
Mailing Address - Country:US
Mailing Address - Phone:787-397-3222
Mailing Address - Fax:
Practice Address - Street 1:URB RIO HONDO 2 CALLE RIO JAJOME AK-16
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00691
Practice Address - Country:US
Practice Address - Phone:787-397-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22603208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice