MEDICARE: DR. HILDA M. RIVERA PSYD

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	3150	PR

General Provider Information

NPI Number	:	1467609834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HILDA M. RIVERA PSYD

Provider Business Mailing Address
First Line	:	2402 CALLE DALIA
Second Line	:	URB VILLA FLORES
City	:	PONCE
State	:	PR
Zip	:	00716-2907
Country	:	US
Telephone Number	:	787-677-0185
Fax Number	:	787-848-5175

Provider Business Practice Location Address
First Line	:	2431 BLVD LUIS A FERRE
Second Line	:	EDIF PORRATA PILA STE 205
City	:	PONCE
State	:	PR
Zip	:	00717-2115
Country	:	US
Telephone Number	:	787-848-5050
Fax Number	:	787-848-5175

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

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	10/17/2020

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