MEDICARE: DR. ANDREA M RIVERA-RAMOS PHD

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	103TC0700X	Clinical Psychologist	7052	PR

General Provider Information

NPI Number	:	1396419677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA M RIVERA-RAMOS PHD

Provider Business Mailing Address
First Line	:	130 CALLE YAGUEZ
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-3149
Country	:	US
Telephone Number	:	787-215-1070
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. EL HIPODROMO CALLE AMERICA 1454
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00909
Country	:	US
Telephone Number	:	787-215-1070
Fax Number	:

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

Provider Enumeration Date	:	08/02/2021
Last Update Date	:	08/02/2021

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