Provider Demographics
NPI:1982638524
Name:RIVERA-PEDROGO, FRANCISCO J (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANCISCO
Middle Name:J
Last Name:RIVERA-PEDROGO
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 244
Mailing Address - Street 2:
Mailing Address - City:MERCEDITA
Mailing Address - State:PR
Mailing Address - Zip Code:00715-0244
Mailing Address - Country:US
Mailing Address - Phone:787-812-5286
Mailing Address - Fax:787-984-2821
Practice Address - Street 1:SAINT LIKE MERMORIAL HOSPITAL
Practice Address - Street 2:CLINICAS EXTERNAS AREA B
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-812-5286
Practice Address - Fax:787-984-2821
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR110082086S0120X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG43446Medicare ID - Type UnspecifiedPEDIATRIC SURGERY