MEDICARE: NATASHA 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	235Z00000X	Speech-Language Pathologist	004038	PR

General Provider Information

NPI Number	:	1437694924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATASHA RIVERA RIVERA

Provider Business Mailing Address
First Line	:	908 CALLE DOLORES P MARCHAND
Second Line	:	URB VILLA RIO CANA
City	:	PONCE
State	:	PR
Zip	:	00728-1928
Country	:	US
Telephone Number	:	787-502-2030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2613 BLVD LUIS A FERRE
Second Line	:	URB CONSTANCIAS
City	:	PONCE
State	:	PR
Zip	:	00717-2106
Country	:	US
Telephone Number	:	787-842-0271
Fax Number	:

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

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	12/20/2016

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Directions to “ NATASHA RIVERA RIVERA ” Practice Location

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