1700932407 NPI number — MRS. BLANCA IVETTE RIVERA AROCHO DPT

Table of content: MRS. BLANCA IVETTE RIVERA AROCHO DPT (NPI 1700932407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700932407 NPI number — MRS. BLANCA IVETTE RIVERA AROCHO DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERA AROCHO
Provider First Name:
BLANCA
Provider Middle Name:
IVETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RIVERA AROCHO
Provider Other First Name:
BLANCA
Provider Other Middle Name:
IVETTE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1700932407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 713
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN SEBASTIAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00685
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-487-6753
Provider Business Mailing Address Fax Number:
787-827-1213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. 124 K.M 1.0 SECTOR FORTUNATO #4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS MARIAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00670-0067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-827-1213
Provider Business Practice Location Address Fax Number:
787-827-1213
Provider Enumeration Date:
01/26/2007

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:  1206 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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