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General NPI Number Information
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NPI Number | 1447389416
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Entity Type | Individual
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Provider Name | MARISOL RIVERA
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | D12 CAMINO DEL CHALET QUINTA DEL RIO
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City | BAYAMON
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State | PR
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Zip | 00961-3012
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Country | US
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Telephone | 787-207-1265
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Fax |
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Provider Business Mailing Address
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Address Line | D12 CAMINO DEL CHALET QUINTA DEL RIO
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City | BAYAMON
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State | PR
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Zip | 00961-3012
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Country | US
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Telephone |
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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 | 247200000X
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Taxonomy Name | Other Technician
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License Number | 6075
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License Number State | PR
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