Provider Demographics
NPI:1700307238
Name:RIVERA MIRABAL, EDUARDO RENE (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:RENE
Last Name:RIVERA MIRABAL
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:SAN JORGE MEDICAL OFFICE BUILDING SUITE 401
Mailing Address - Street 2:252 SAN JORGE STREET
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-990-4900
Mailing Address - Fax:840-400-4826
Practice Address - Street 1:7900 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-5405
Practice Address - Country:US
Practice Address - Phone:727-869-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1586902084P0800X
PR245052084P0800X
NY3193122084P0800X
TXT38622084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry