Healthcare Provider Details

I. General information

NPI: 1639405814
Provider Name (Legal Business Name): IRMA CARMEN RIVERA ESQUERDO RRT,RPSGT.CPFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: IRMA CARMEN R. ESQUERDO

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5025 VIA CANGREJOS CAMINO DEL MAR
TOA BAJA PR
00949-4347
US

IV. Provider business mailing address

5025 VIA CANGREJOS CAMINO DEL MAR CAMINO DEL MAR
TOA BAJA PR
00949-0000
US

V. Phone/Fax

Practice location:
  • Phone: 787-525-1048
  • Fax: 787-221-4979
Mailing address:
  • Phone: 787-525-1048
  • Fax: 787-221-4979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number00414
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License Number00414
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code2279P1004X
TaxonomyPulmonary Diagnostics Registered Respiratory Therapist
License Number00414
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code2279P3900X
TaxonomyNeonatal/Pediatric Registered Respiratory Therapist
License Number00414
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: