Provider Demographics
NPI:1104032812
Name:RIVERA-IGUINA, MARICARMEN (BSW)
Entity Type:Individual
Prefix:MRS
First Name:MARICARMEN
Middle Name:
Last Name:RIVERA-IGUINA
Suffix:
Gender:F
Credentials:BSW
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 1271
Mailing Address - Street 2:BARRIO NAVARRO
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-1271
Mailing Address - Country:US
Mailing Address - Phone:787-747-2363
Mailing Address - Fax:
Practice Address - Street 1:900 CALLE CERRA
Practice Address - Street 2:PDA 15 CDT GUALBERTO RABELL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-5104
Practice Address - Country:US
Practice Address - Phone:787-747-2363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3799104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker