Healthcare Provider Details

I. General information

NPI: 1770465486
Provider Name (Legal Business Name): KRITZIANEL RIVERA SOTO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EST DE FLORIDA 135 CALLE AVALON
BARCELONETA PR
00617-3068
US

IV. Provider business mailing address

EST DE FLORIDA 135 CALLE AVALON
BARCELONETA PR
00617-3068
US

V. Phone/Fax

Practice location:
  • Phone: 939-241-5480
  • Fax:
Mailing address:
  • Phone: 939-241-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8530
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: