Individual
DR. JEAN PAUL INESTA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
119 OAKFIELD DR, BRANDON, FL 33511-5779
(813) 681-5551
(813) 916-2944
Mailing address
SUITE 261, PO BOX 19400, SAN JUAN, PR 00919-4000
(787) 406-3197
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22585
PR
390200000X
Student in an Organized Health Care Education/Training Program
5039722
PR
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22585
MEDICAL LICENSE
PR
01
—
5039722
DRIVER LICENSE
PR
Enumeration date
04/18/2019
Last updated
12/20/2021
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