Provider Demographics
NPI:1205973310
Name:RIVERA, NORMA IRIS (MD)
Entity type:Individual
Prefix:DR
First Name:NORMA
Middle Name:IRIS
Last Name: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:HC 6 BOX 13200
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685-9855
Mailing Address - Country:US
Mailing Address - Phone:787-280-3173
Mailing Address - Fax:787-896-4570
Practice Address - Street 1:HC 7 BOX 14000
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-9401
Practice Address - Country:US
Practice Address - Phone:787-896-6975
Practice Address - Fax:787-896-4570
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE71294Medicare UPIN