Healthcare Provider Details

I. General information

NPI: 1033046875
Provider Name (Legal Business Name): BETSY RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. PR 21 INT. PR 18 BO. MONACILLO URBANO
SAN JUAN PR
00927
US

IV. Provider business mailing address

CALLE PARIS 171 PMB 1406
SAN JUAN PR
00917
US

V. Phone/Fax

Practice location:
  • Phone: 787-936-1477
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: