Healthcare Provider Details

I. General information

NPI: 1487561692
Provider Name (Legal Business Name): ANDREA PAOLA RIVERA LAFORET PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CAR 2 K156 H5 VISTA VERDE SHOPPING
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

URB. BORINQUEN J1 CALLE FRANCISCO OLLER
CABO ROJO PR
00623
US

V. Phone/Fax

Practice location:
  • Phone: 787-597-7061
  • Fax:
Mailing address:
  • Phone: 787-413-8485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4163
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: