Provider Demographics
NPI:1972616563
Name:RIVERA-VIRELLA, MARINA E (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:E
Last Name:RIVERA-VIRELLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:E2 CALLE CHESTNUT HL
Mailing Address - Street 2:CAMBRIDGE PARK
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-1451
Mailing Address - Country:US
Mailing Address - Phone:787-754-6085
Mailing Address - Fax:787-765-4577
Practice Address - Street 1:354 CALLE 32
Practice Address - Street 2:VILLA NEVAREZ
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-5110
Practice Address - Country:US
Practice Address - Phone:787-754-6085
Practice Address - Fax:787-765-4577
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PR78212084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRD-32341Medicare UPIN
PR29532Medicare ID - Type Unspecified