Healthcare Provider Details

I. General information

NPI: 1598441545
Provider Name (Legal Business Name): AMBAR GALLARDO RIVERA NL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 08/02/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CALLE CONSTITUCION
SAN JUAN PR
00920-3864
US

IV. Provider business mailing address

5890 CALLE TARTAK APT A903
CAROLINA PR
00979-5926
US

V. Phone/Fax

Practice location:
  • Phone: 787-507-0465
  • Fax:
Mailing address:
  • Phone: 787-234-6934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number232
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: