MEDICARE: BERAINE NICOLE RIVERA RIVERA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	7245	PR

General Provider Information

NPI Number	:	1174466262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERAINE NICOLE RIVERA RIVERA

Provider Business Mailing Address
First Line	:	PO BOX 731
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0731
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB. INDUSTRIAL, CARR. 64 ESQUINA, CALLE 3
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680
Country	:	US
Telephone Number	:	787-360-9952
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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