Provider Demographics
NPI:1336599158
Name:RIVERA CARDONA, GABRIELA (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIELA
Middle Name:
Last Name:RIVERA CARDONA
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:ST EL YUNQUE B10 COLINAS METROPOLITANAS
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00969
Mailing Address - Country:UM
Mailing Address - Phone:787-758-2525
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA #2 KM 47.7
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR21763207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program