Provider Demographics
NPI:1861477580
Name:RIVERO ITURREGUI, MANUEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:A
Last Name:RIVERO ITURREGUI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 CALLE LOIZA
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1801
Mailing Address - Country:US
Mailing Address - Phone:787-726-5486
Mailing Address - Fax:787-728-6031
Practice Address - Street 1:1760 CALLE LOIZA
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00911-1801
Practice Address - Country:US
Practice Address - Phone:787-726-5486
Practice Address - Fax:787-728-6031
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2019-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11419207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology