Provider Demographics
NPI:1942500954
Name:GUILLOTY RIVERA, ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:
Last Name:GUILLOTY 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 143195
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3195
Mailing Address - Country:US
Mailing Address - Phone:787-933-3392
Mailing Address - Fax:787-650-8257
Practice Address - Street 1:PR- 129 KM 9.2
Practice Address - Street 2:
Practice Address - City:HATILLO
Practice Address - State:PR
Practice Address - Zip Code:00659-9798
Practice Address - Country:US
Practice Address - Phone:787-672-1835
Practice Address - Fax:787-650-8257
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18011208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR18011OtherTHE PUERTO RICO BOARD OF LICENSING AND MEDICAL DISCIPLINES