Provider Demographics
NPI:1023060563
Name:CORDOVA-RIVERA, HECTOR R (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:R
Last Name:CORDOVA-RIVERA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:I7 CALLE EBANO
Mailing Address - Street 2:APT 703
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-3100
Mailing Address - Country:US
Mailing Address - Phone:787-781-8519
Mailing Address - Fax:787-641-4561
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:MEDICAL SERVICE (111)
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:787-641-4561
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2011-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR7397207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR7397OtherMEDICAL LICENSE NUMBER