Provider Demographics
NPI:1790862894
Name:RIVERA, MILAGROS (MD)
Entity Type:Individual
Prefix:MRS
First Name:MILAGROS
Middle Name:
Last Name:RIVERA
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:PO BOX 11801
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1801
Mailing Address - Country:US
Mailing Address - Phone:787-792-4142
Mailing Address - Fax:
Practice Address - Street 1:#1 PINEIRO ST ESQ VALLEJO
Practice Address - Street 2:CMS DR JAVIER JAVIER ANTON
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00925
Practice Address - Country:US
Practice Address - Phone:787-763-4242
Practice Address - Fax:787-763-3175
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4331208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics