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General NPI Number Information
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NPI Number | 1023187846
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Entity Type | Individual
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Provider Name | AIXA RIVERA O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 525 AVE ROOSEVELT PLAZA LAS AMERICAS SUITE 173
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-777-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 525 AVE ROOSEVELT PLAZA LAS AMERICAS SUITE 173
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City | SAN JUAN
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State | PR
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Zip | 00918
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Country | US
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Telephone | 787-777-0990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 282
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License Number State | PR
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