1568723963 NPI number — MRS. MILAGROS RIVERA I CPL

Table of content: MRS. MILAGROS RIVERA I CPL (NPI 1568723963)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568723963 NPI number — MRS. MILAGROS RIVERA I CPL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA
Provider First Name:
MILAGROS
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
I
Provider Credential Text:
CPL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIVERA
Provider Other First Name:
MILAGROS
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CPL
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1568723963
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC-3
Provider Second Line Business Mailing Address:
BOX 15424
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623-9203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-531-4915
Provider Business Mailing Address Fax Number:
787-851-7840

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13-201 CONDOMINIO ARMONIA
Provider Second Line Business Practice Location Address:
LOS PRADOS
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00727-3280
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-531-4915
Provider Business Practice Location Address Fax Number:
787-851-7840
Provider Enumeration Date:
06/01/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 0293 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 0293 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YS0200X , with the licence number: 61135 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)