Provider Demographics
NPI:1194980847
Name:RIVERA, SONIA YOLANDA (MD)
Entity type:Individual
Prefix:DR
First Name:SONIA
Middle Name:YOLANDA
Last Name:RIVERA
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 1:12 AVE PARQUE DE LOS NINOS
Mailing Address - Street 2:APT 10-A- 2 BOX 183
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5501
Mailing Address - Country:US
Mailing Address - Phone:787-287-7164
Mailing Address - Fax:787-287-7164
Practice Address - Street 1:12 AVE PARQ DE LOS NINOS
Practice Address - Street 2:APT 10-A- 2 BOX 183
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5501
Practice Address - Country:US
Practice Address - Phone:787-287-7164
Practice Address - Fax:787-287-7164
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12750208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice