Provider Demographics
NPI:1003110727
Name:GARCIA RIVERA, MARIED DEL C
Entity Type:Individual
Prefix:
First Name:MARIED
Middle Name:DEL C
Last Name:GARCIA RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 271
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0271
Mailing Address - Country:US
Mailing Address - Phone:787-450-0035
Mailing Address - Fax:
Practice Address - Street 1:VILLA ROSA 1 B 7
Practice Address - Street 2:AVE LOS VETERANOS
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-450-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR704235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist