Provider Demographics
NPI:1891951448
Name:RIVAS ORTIZ, RICARDO J (MD)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:J
Last Name:RIVAS ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RICARDO
Other - Middle Name:J
Other - Last Name:RIVAS ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:RR 36 BOX 1455
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9719
Mailing Address - Country:US
Mailing Address - Phone:787-605-8781
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY DISTRICT HOSPITAL
Practice Address - Street 2:MEDICAL CENTER UDH2 PO 2116
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922-2116
Practice Address - Country:US
Practice Address - Phone:787-758-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR180472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty