Provider Demographics
NPI:1124312657
Name:OLIVERO-RIVERA, SULEYKA MILAGROS
Entity type:Individual
Prefix:
First Name:SULEYKA
Middle Name:MILAGROS
Last Name:OLIVERO-RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 800068
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0068
Mailing Address - Country:US
Mailing Address - Phone:787-844-2078
Mailing Address - Fax:787-844-2545
Practice Address - Street 1:HOSPITAL SAN LUCAS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716
Practice Address - Country:US
Practice Address - Phone:787-844-2078
Practice Address - Fax:787-844-2545
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18,668208M00000X
390200000X
PR18668207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program