Individual
GRISELL RIVERA ALICEA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
EDIF PARRAS, STE 105, PONCE, PR 00717-1321
(787) 259-1230
(787) 259-1585
Mailing address
2225 PONCE BY PASS EDIF PARRAS, STE 105, PONCE, PR 00717-1320
(787) 259-1230
(787) 259-1585
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
11615
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11615
MEDICAL LICENSE
PR
Enumeration date
07/05/2007
Last updated
09/04/2013
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