Provider Demographics
NPI:1124886940
Name:RIVERA FLORES, GREMARIE (MD)
Entity type:Individual
Prefix:DR
First Name:GREMARIE
Middle Name:
Last Name:RIVERA FLORES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23007 CARR 743
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9433
Mailing Address - Country:US
Mailing Address - Phone:787-204-1883
Mailing Address - Fax:
Practice Address - Street 1:23007 CARR 743
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-9433
Practice Address - Country:US
Practice Address - Phone:787-204-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23695208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice