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General NPI Number Information
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NPI Number | 1467719195
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Entity Type | Individual
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Provider Name | MISS SHEILA M RIVERA
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Gender | Female
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Dates
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Enumeration Date | 04/19/2012
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | URBANIZACION EL REAL CALLE PALACIO # 64
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City | SAN GERMAN
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State | PR
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Zip | 00683
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Country | US
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Telephone | 787-503-3421
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Fax |
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Provider Business Mailing Address
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Address Line | RESIDENCIAL LAS LOMAS EDF. 5 APT 88
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City | SAN GERMAN
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State | PR
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Zip | 00683
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 10767
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License Number State | PR
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