Healthcare Provider Details

I. General information

NPI: 1366143166
Provider Name (Legal Business Name): TANIA RIVERA RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2023
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 566 KM 2.2
OROCOVIS PR
00720
US

IV. Provider business mailing address

HC 1 BOX 5453
OROCOVIS PR
00720-9227
US

V. Phone/Fax

Practice location:
  • Phone: 787-316-2518
  • Fax:
Mailing address:
  • Phone: 787-316-2518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16473
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: