Individual provider Active NPI

Manuela A Fonseca Rivera

  • General Practice Physician
  • Rio Piedras, PR
National Provider Identifier
1477655611
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
BF2810871 Issued in PR
Practice address
Calle Georgetti #122
Ambulatory Medical Services
Rio Piedras, PR 00925
Phone
(787) 758-1718
Fax
(787) 758-1718
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X BF2810871 PR Primary
General Practice Physician 208D00000X DM097915 PR

Addresses

Primary practice location

Calle Georgetti #122
Ambulatory Medical Services
Rio Piedras, PR 00925

Mailing address

Urb Pacifica P6 121
Via Arcoiris Encantada
Trujillo Alto, PR 00976
Phone (787) 755-8786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BF2810871PRMDGeneral Practice Physician
DM097915PRMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477655611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB PACIFICA P6 121",
            "address_2": "VIA ARCOIRIS ENCANTADA",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "00976",
            "telephone_number": "787-755-8786",
            "fax_number": "787-758-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE GEORGETTI #122",
            "address_2": "AMBULATORY MEDICAL SERVICES",
            "city": "RIO PIEDRAS",
            "state": "PR",
            "postal_code": "00925",
            "telephone_number": "787-758-1718",
            "fax_number": "787-758-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONSECA RIVERA",
        "first_name": "MANUELA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "BF2810871",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "DM097915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Piedras, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.