Provider Demographics
NPI:1043406614
Name:MEDINA-RIVERA, BIOMARIS (MD)
Entity type:Individual
Prefix:
First Name:BIOMARIS
Middle Name:
Last Name:MEDINA-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:CALLE PEDRO PEDROZA A12
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ROAD 14 KM. 72.2 BO. RINCON SECTOR LOMAS
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-2800
Practice Address - Country:US
Practice Address - Phone:787-535-1001
Practice Address - Fax:787-535-1012
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17199207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine