MEDICARE: MISS ZULMA I RIVERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	PCVTE4593	PR

General Provider Information

NPI Number	:	1336433259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ZULMA I RIVERA

Provider Business Mailing Address
First Line	:	PO BOX 804
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-0804
Country	:	US
Telephone Number	:	787-617-3111
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. LLANOS 4TH ST. #F-21
Second Line	:
City	:	SANTA ISABEL
State	:	PR
Zip	:	00757-0804
Country	:	US
Telephone Number	:	787-617-3111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2011
Last Update Date	:	06/08/2011

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Directions to “ MISS ZULMA I RIVERA ” Practice Location

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