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NPI Code Detail

MEDICARE: JOHAMARYS D RIVERA SANTANA PSYD

MEDICARE:   JOHAMARYS D RIVERA SANTANA  PSYD
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
1103T00000XPsychologist8861PR

General Provider Information

NPI Number : 1508710112
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHAMARYS D RIVERA SANTANA PSYD
Provider Business Mailing Address
First Line : 5005 CAMINO DEL MAR VIA CANGREJOS
Second Line :
City : TOA BAJA
State : PR
Zip : 00949
Country : US
Telephone Number : 787-949-5557
Fax Number :
Provider Business Practice Location Address
First Line : 1012 AVE DOS PALMAS
Second Line :
City : TOA BAJA
State : PR
Zip : 00949-4101
Country : US
Telephone Number : 787-949-5557
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2026
Last Update Date : 04/17/2026

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Directions to “ JOHAMARYS D RIVERA SANTANA PSYD” Practice Location

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