Provider Demographics
NPI:1699895813
Name:RIVERA-DELGADO, MARIEL (MD)
Entity type:Individual
Prefix:DR
First Name:MARIEL
Middle Name:
Last Name:RIVERA-DELGADO
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:CALLE 1 B13 EXT. VILLAS DEL PILAR
Mailing Address - Street 2:
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735
Mailing Address - Country:US
Mailing Address - Phone:787-244-0990
Mailing Address - Fax:
Practice Address - Street 1:CALLE 1 B13
Practice Address - Street 2:EXT. VILLAS DEL PILAR
Practice Address - City:CEIBA
Practice Address - State:PR
Practice Address - Zip Code:00735
Practice Address - Country:US
Practice Address - Phone:787-244-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12481208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty