Provider Demographics
NPI:1295476620
Name:RIVERA SANTIAGO, HECTOR RICARDO (MD)
Entity type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:RICARDO
Last Name:RIVERA SANTIAGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:URB EL MIRADOR DE CUPEY
Mailing Address - Street 2:M1 CALLE 10
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7588
Mailing Address - Country:US
Mailing Address - Phone:787-340-5104
Mailing Address - Fax:
Practice Address - Street 1:2225 PONCE BYP STE 407
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1322
Practice Address - Country:US
Practice Address - Phone:787-840-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH52.254613207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine