Provider Demographics
NPI:1669743415
Name:OSCAR RIVERA MARTINEZ PSC
Entity type:Organization
Organization Name:OSCAR RIVERA MARTINEZ PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-743-5370
Mailing Address - Street 1:PO BOX 6299
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-6299
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 CALLE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MALL CIE, SUITE 61
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-743-5370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8547207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE40901Medicare UPIN