MEDICARE: NESTOR RIVERA LPC

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	101YP2500X	Professional Counselor	1598	PR

General Provider Information

NPI Number	:	1255873006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NESTOR RIVERA LPC

Provider Business Mailing Address
First Line	:	V17 CALLE 25
Second Line	:	VISTA AZUL
City	:	ARECIBO
State	:	PR
Zip	:	00612-2619
Country	:	US
Telephone Number	:	787-210-6880
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 AVE MIRAMAR
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-4371
Country	:	US
Telephone Number	:	787-210-6880
Fax Number	:

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

Provider Enumeration Date	:	11/10/2016
Last Update Date	:	11/10/2016

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Directions to “ NESTOR RIVERA LPC” Practice Location

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