Provider Demographics
NPI:1932129194
Name:RIVERA, LILIA I (MD)
Entity Type:Individual
Prefix:
First Name:LILIA
Middle Name:I
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:239 AVE ARTERIAL HOSTOS
Mailing Address - Street 2:CAPITAL CENTER 306
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1474
Mailing Address - Country:US
Mailing Address - Phone:787-250-1746
Mailing Address - Fax:787-250-1746
Practice Address - Street 1:239 AVE ARTERIAL HOSTOS
Practice Address - Street 2:CAPITAL CENTER 306
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1474
Practice Address - Country:US
Practice Address - Phone:787-250-1746
Practice Address - Fax:787-250-1746
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR8335207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR83501 BMedicare ID - Type UnspecifiedGROUP NUMBER
PR80378Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER
PRB63429Medicare UPIN