Healthcare Provider Details

I. General information

NPI: 1780442905
Provider Name (Legal Business Name): MISS DEBORAH N/A RIVERA ORTIZ JR.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DEBORAH RIVERA TRABAJADORA SOCIAL

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMUNIDAD ARCADIO MALDONADO CALLE 2 #4
SALINAS PR
00751-2573
US

IV. Provider business mailing address

252 CALLE DIOSDADO DONES
SALINAS PR
00751-2573
US

V. Phone/Fax

Practice location:
  • Phone: 787-359-1277
  • Fax:
Mailing address:
  • Phone: 787-359-1277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16498
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: