Provider Demographics
NPI:1699873950
Name:RIVERA, MARALEXIS (MD)
Entity type:Individual
Prefix:DR
First Name:MARALEXIS
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CALLE COBANA
Mailing Address - Street 2:URB. LADERAS DE SAN JUAN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9322
Mailing Address - Country:US
Mailing Address - Phone:787-474-3110
Mailing Address - Fax:
Practice Address - Street 1:AVE. AMERICO MIRANDA
Practice Address - Street 2:CENTRO MEDICO - HOSPITAL PEDIATRICO UNIVERSITARIO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14078261QM0855X, 273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Not Answered273R00000XHospital UnitsPsychiatric Unit