Provider Demographics
NPI:1134359219
Name:DONIS RIVERA, ROSAMAR (MD)
Entity type:Individual
Prefix:MS
First Name:ROSAMAR
Middle Name:
Last Name:DONIS RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSAMAR
Other - Middle Name:
Other - Last Name:DONIS RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:CAROLINA ALTA
Mailing Address - Street 2:MILAGROS CABEZA J10
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-7133
Mailing Address - Country:US
Mailing Address - Phone:787-513-1785
Mailing Address - Fax:
Practice Address - Street 1:CAROLINA ALTA
Practice Address - Street 2:MILAGROS CABEZA J10
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-7133
Practice Address - Country:US
Practice Address - Phone:787-513-1785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17616208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice