Provider Demographics
NPI:1801856026
Name:RIVERA SANTOS, ANGEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:B
Last Name:RIVERA SANTOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 494
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0494
Mailing Address - Country:US
Mailing Address - Phone:787-840-1455
Mailing Address - Fax:787-848-4657
Practice Address - Street 1:2275 PONCE BY PASS
Practice Address - Street 2:CARIBBEAN MEDICAL CENTER
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1380
Practice Address - Country:US
Practice Address - Phone:787-840-1455
Practice Address - Fax:787-848-4657
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12002207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG21665Medicare UPIN
PR0088549Medicare ID - Type Unspecified