Provider Demographics
NPI:1962043844
Name:ALVAREZ RIVERA, EMANUEL (MD)
Entity Type:Individual
Prefix:
First Name:EMANUEL
Middle Name:
Last Name:ALVAREZ RIVERA
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:PO BOX 3252
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-3252
Mailing Address - Country:US
Mailing Address - Phone:787-201-3113
Mailing Address - Fax:
Practice Address - Street 1:53 AVE BARBOSA
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4329
Practice Address - Country:US
Practice Address - Phone:787-201-3113
Practice Address - Fax:787-815-7953
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21559208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice