Most Relevant Information
Provider Data
| NPI Number: | 1003458092 |
| Provider Name: | JOHNATTAN RIVERA-DEVARIE |
| Entity Type: | Individual |
| Taxonomy Code: | 247100000X |
| Specialty: | Radiologic Technologist |
| License Number: | 3172 |
Most Important Dates
| Enumeration Date: | 10/11/2019 |
| Last Updated: | 10/11/2019 |
Provider Practice Location
99 CALLE GUILLERMO RIEFKHOL
PATILLAS
PR
00723
Practice Location Phone/Fax
| Phone: | 7878394320 |
| Fax: | 7872710004 |
Provider Mailing Location
PO BOX 697
PATILLAS
PR
007230697
Provider Mailing Phone/Fax
| Phone: | 7878394320 |
| Fax: | 7872710004 |