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General NPI Number Information
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NPI Number | 1629912886
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Entity Type | Individual
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Provider Name | RANDY JOSUE GEORGE RIVERA
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Gender | Male
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | CENTRO MEDICO DE PUERTO RICO CAMARA HIPERBARICA
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City | SAN JUAN
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State | PR
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Zip | 00935-0001
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Country | US
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Telephone | 787-777-3535
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Fax |
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Provider Business Mailing Address
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Address Line | CONDOMINIO ACUAPARQUE APARTAMENTO 3B
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City | TOA BAJA
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State | PR
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Zip | 00949
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Country | US
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Telephone | 787-469-5275
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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 | 163WM1400X
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Taxonomy Name | Nurse Massage Therapist (NMT)
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License Number | 97023
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License Number State | PR
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