Provider Demographics
NPI:1003510694
Name:RIVERA MALDONADO, CRISTINA (RN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:RIVERA MALDONADO
Suffix:
Gender:F
Credentials:RN
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 857
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0857
Mailing Address - Country:US
Mailing Address - Phone:939-525-5971
Mailing Address - Fax:
Practice Address - Street 1:URB ALTURAS DE UTUADO
Practice Address - Street 2:
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641-0064
Practice Address - Country:US
Practice Address - Phone:939-525-5971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4594163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)