Brenda Luz Rivera Fuentes, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

24148 Issued in PR

Practice address

100 Carr 165 Torre 1 Suite 303
Guaynabo, PR 00968

Phone

(787) 277-0847

NPI assigned

May 6, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• F Sepulveda Physiatry & Sports Medicine

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Guaynabo, PR
  • NPI 1841742459
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1083350623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 925",
            "city": "DORADO",
            "state": "PR",
            "postal_code": "006460925",
            "telephone_number": "787-250-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CARR 165 TORRE 1 SUITE 303",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "00968",
            "telephone_number": "787-277-0847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA FUENTES",
        "first_name": "BRENDA",
        "middle_name": "LUZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "1270-PA",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "24148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabel Rivera Colon, 0686P
• Benedicto Rivera Cruz, 0097B
• Victor J Rivera Cruz, M.D.
• Jose Raul Rivera Diaz, PHARMACY TECHNICIAN
• Kelly Lynn Rivera Escobar
• Griseli Rivera Gonzalez, RD
• Lydia Rivera Gonzalez, 1025P
• Liliana I Rivera Gracia, M.S.S.L.P.
• Wisael Rivera Hernandez, 1336P
• Eneris M Rivera Iturrino, PSY.D.

• General Practice Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.