Healthcare Provider Details

I. General information

NPI: 1013429505
Provider Name (Legal Business Name): ALEXIS FRANCISCO RIVERA CUEVAS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2017
Last Update Date: 09/24/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB. ALTURAS DE SAN JOSE CALLE 19 KK13
SABANA GRANDE PR
00637
US

IV. Provider business mailing address

URB. ALTURAS DE SAN JOSE CALLE 19 KK13
SABANA GRANDE PR
00637
US

V. Phone/Fax

Practice location:
  • Phone: 787-299-7703
  • Fax:
Mailing address:
  • Phone: 787-543-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5981
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: