Individual provider · NPI-1

Rodolfo Reniel Alicea Rivera, MD

General Practice · Bayamon, PR

NPI number1891548343

StatusActive

Last updated in NPPESMay 12, 2025

Details

NPI: 1891548343
Entity type: Individual (NPI-1)
Name: Rodolfo Reniel Alicea Rivera
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Apr 5, 2024
Certification date: May 12, 2025
Last updated: May 12, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208D00000X	General Practice	37240	PR	Yes
208100000X	Physical Medicine & Rehabilitation	TRN41896	FL
390200000X	Student in an Organized Health Care Education/Training Program	–	–

Practice location

100 Ave Laurel
Bayamon, PR 00956-4816

Phone 787-787-5151

Mailing address

385 Calle Jacinto
Carolina, PR 00987-2226

Phone 787-752-1020

Other practice locations

7031 Sw 62nd Ave
South Miami, FL 33143-4701

Phone 305-284-7500

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