Provider Demographics
NPI:1154424075
Name:RIVERA, ROSALIA (RPT)
Entity type:Individual
Prefix:MRS
First Name:ROSALIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CALLE PATRON
Mailing Address - Street 2:
Mailing Address - City:MOROVIS
Mailing Address - State:PR
Mailing Address - Zip Code:00687-3026
Mailing Address - Country:US
Mailing Address - Phone:787-862-7439
Mailing Address - Fax:
Practice Address - Street 1:11 CALLE PATRON
Practice Address - Street 2:
Practice Address - City:MOROVIS
Practice Address - State:PR
Practice Address - Zip Code:00687-3026
Practice Address - Country:US
Practice Address - Phone:787-862-7439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3302822OtherACAA
PR89228OtherTRIPLE S
PR50105AOtherPREFFERED MEDICARE CHOICE
PR660538648OtherTRICARE
PR6870000OtherHUMANA HEALTH
PR2687OtherFIRST MEDICAL
PR870024OtherMEDICARE Y MUCHO MAS
PR6605388648OtherFIRST PLUS
PR8937706OtherCIGNA
PR20674OtherMEDICAL CARD SYSTEM
PR36655OtherASOCIACION DE MAESTROS
PR587786692OtherCOSVI
PR6870000OtherHUMANA HEALTH