1447595145 NPI number — MRS. JACQUELINE DEL PILAR RIERA PHYSICAL THERAPIST

Table of content: MRS. JACQUELINE DEL PILAR RIERA PHYSICAL THERAPIST (NPI 1447595145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447595145 NPI number — MRS. JACQUELINE DEL PILAR RIERA PHYSICAL THERAPIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIERA
Provider First Name:
JACQUELINE
Provider Middle Name:
DEL PILAR
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PHYSICAL THERAPIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447595145
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8888 COLLINS AVENUE
Provider Second Line Business Mailing Address:
APT. 406
Provider Business Mailing Address City Name:
SURFSIDE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33154-3541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8888 COLLINS AVE
Provider Second Line Business Practice Location Address:
APT. 406
Provider Business Practice Location Address City Name:
SURFSIDE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33154-3539
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-864-2674
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/06/2012

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: 225100000X , with the licence number:  PT23650 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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