Healthcare Provider Details

I. General information

NPI: 1861799348
Provider Name (Legal Business Name): SHEILA ISABEL RIVERA-GONZALEZ MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27-16 AVE ROBERTO CLEMENTE
CAROLINA PR
00985-5420
US

IV. Provider business mailing address

HC 5 BOX 91525
ARECIBO PR
00612-9517
US

V. Phone/Fax

Practice location:
  • Phone: 787-276-8123
  • Fax:
Mailing address:
  • Phone: 787-450-2329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number911
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: