Healthcare Provider Details

I. General information

NPI: 1811446230
Provider Name (Legal Business Name): NATHALIE MARIE RIVERA-MORALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2016
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF PUERTO RICO RECINTO DE CIENCIAS MEDICAS APARTADO 365067
SAN JUAN PR
00936-5067
US

IV. Provider business mailing address

D6 CALLE 2 HACIENDAS EL ZORZAL
BAYAMON PR
00956
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • Fax:
Mailing address:
  • Phone: 787-359-3524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number22379
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number22379
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: