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General NPI Number Information
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NPI Number | 1932596830
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Entity Type | Individual
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Provider Name | MIRELIS DEL CARMEN RIVERA-RODRIGUEZ MPT
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Gender | Female
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Dates
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Enumeration Date | 04/20/2015
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Last Update Date | 04/20/2015
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Provider Practice Location Address
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Address Line | 1260 CALLE 54 SE URB. LA RIVIERA
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City | SAN JUAN
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State | PR
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Zip | 00921-3143
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Country | US
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Telephone | 787-999-5538
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Fax |
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Provider Business Mailing Address
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Address Line | 1260 CALLE 54 SE URBANIZACION LA RIVIERA
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City | SAN JUAN
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State | PR
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Zip | 00921-3143
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4509
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License Number State | PR
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