Organization
CDT RIVERA LABARCA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YONATHAN RIVERA JIMENEZ (ADMINISTRATOR)
(787) 846-6890
Entity
Organization
Contact information
Practice address
1 CALLE TOMAS DAVILA, BARCELONETA, PR 00617-2736
(787) 846-6890
(787) 846-5458
Mailing address
PO BOX 359, BARCELONETA, PR 00617-0359
(787) 846-6890
(787) 846-5458
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
85
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85
STATE LICENSE
PR
Enumeration date
05/04/2006
Last updated
08/22/2020
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