Healthcare Provider Details

I. General information

NPI: 1497471452
Provider Name (Legal Business Name): JOSUE PABLO SALVAT RIVERA SR. BSN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JESUS RIVERA VEGA SR. BSN

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. LOS AIRES B 22 CALLE CROMO
ARECIBO PR
00612-8855
US

IV. Provider business mailing address

URB. LOS AIRES 42 CALLE CROMO
ARECIBO PR
00612
US

V. Phone/Fax

Practice location:
  • Phone: 787-649-7261
  • Fax:
Mailing address:
  • Phone: 787-649-7261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC3500X
TaxonomyCardiac Rehabilitation Registered Nurse
License Number34757
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number34757
License Number StatePR
# 3
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number34757
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number34757
License Number StatePR
# 5
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number34757
License Number StatePR
# 6
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number34757
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number34757
License Number StatePR
# 8
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number34757
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: