Jose Rene Rivera Diaz, SW
Individual provider Active NPI Social Worker · Comerio, PR
NPI 1356860076 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1356860076
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 12858 (PR)
- Practice address
- 7780 Bo Dona Elena Alto #KM4.1
Comerio, PR 00782 - Phone
- (787) 502-6007
- NPI assigned
- Sep 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12858 | PR | MD | Obstetrics Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | 12858 | PR | Yes |
Addresses
Primary practice location
7780 Bo Dona Elena Alto #KM4.1
Comerio, PR 00782
Mailing address
Hc03Box7684
Comerio, PR 00782
Phone (787) 502-6007
Other providers in Comerio, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.