Healthcare Provider Details

I. General information

NPI: 1447181060
Provider Name (Legal Business Name): WILBERT RIVERA MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 CALLE CARAZO
GUAYNABO PR
00969-5714
US

IV. Provider business mailing address

PO BOX 529
LOIZA PR
00772-0529
US

V. Phone/Fax

Practice location:
  • Phone: 787-402-8855
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15726
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: