Provider Demographics
NPI:1831762574
Name:RIVERA COLOM, NATALIA MARIE (MD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:MARIE
Last Name:RIVERA COLOM
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 1:671 CALLE DIEGO CUELLAR
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7614
Mailing Address - Country:US
Mailing Address - Phone:787-451-0364
Mailing Address - Fax:
Practice Address - Street 1:671 CALLE DIEGO CUELLAR
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-7614
Practice Address - Country:US
Practice Address - Phone:781-451-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22432208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice