Provider Demographics
NPI:1275062671
Name:RIVERA, EMANUEL BERNARDI (MD)
Entity type:Individual
Prefix:
First Name:EMANUEL
Middle Name:BERNARDI
Last Name: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 1:850 CALLE EIDER APT 707B
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00924-2387
Mailing Address - Country:US
Mailing Address - Phone:939-458-7858
Mailing Address - Fax:
Practice Address - Street 1:URB VILLA CARMEN
Practice Address - Street 2:K13 CALLE BAYAMON
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6108
Practice Address - Country:US
Practice Address - Phone:787-743-8730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23749208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation