Healthcare Provider Details

I. General information

NPI: 1346133139
Provider Name (Legal Business Name): WILMER ALFREDO RIVERA TORRES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 AVE WILSON STE 304
SAN JUAN PR
00907-2364
US

IV. Provider business mailing address

868 STREET 15, URB. MONTE CARLO
SAN JUAN PR
00924
US

V. Phone/Fax

Practice location:
  • Phone: 787-489-0088
  • Fax:
Mailing address:
  • Phone: 787-527-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-407473
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8532
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: