MEDICARE: MS. FLORITA RIVERA-MARTINEZ

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	163W00000X	Registered Nurse	725712	NY

General Provider Information

NPI Number	:	1194269654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FLORITA RIVERA-MARTINEZ

Provider Business Mailing Address
First Line	:	878 CALLE ZUMBADOR
Second Line	:	URB. COUNTRY CLUB
City	:	SAN JUAN
State	:	PR
Zip	:	00924-3306
Country	:	US
Telephone Number	:	787-529-8780
Fax Number	:

Provider Business Practice Location Address
First Line	:	878 CALLE ZUMBADOR
Second Line	:	URB. COUNTRY CLUB
City	:	SAN JUAN
State	:	PR
Zip	:	00924-3306
Country	:	US
Telephone Number	:	787-529-8780
Fax Number	:

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

Provider Enumeration Date	:	12/16/2016
Last Update Date	:	12/16/2016

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