Provider Demographics
NPI:1760680383
Name:RIVERO, VICTOR RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:RAFAEL
Last Name:RIVERO
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 1:43 CALLE HUCARES
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-3562
Mailing Address - Country:US
Mailing Address - Phone:716-908-0834
Mailing Address - Fax:
Practice Address - Street 1:VICTOR ROJAS #2 CARR 129
Practice Address - Street 2:ZONA INDUSTRIAL
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:716-908-0834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18790207U00000X, 207L00000X, 207U00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology