Provider Demographics
NPI:1821233735
Name:RIVERA-CABAN, CARLOS MIGUEL (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MIGUEL
Last Name:RIVERA-CABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 AVE TITO CASTRO STE 602
Mailing Address - Street 2:TORRE MEDICA SAN LUCAS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-4721
Mailing Address - Country:US
Mailing Address - Phone:787-651-1429
Mailing Address - Fax:787-651-1430
Practice Address - Street 1:909 AVE TITO CASTRO STE 602
Practice Address - Street 2:TORRE MEDICA SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4721
Practice Address - Country:US
Practice Address - Phone:787-651-1429
Practice Address - Fax:787-651-1430
Is Sole Proprietor?:No
Enumeration Date:2008-12-05
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1325282086S0129X
390200000X
PR237072086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program