Provider Demographics
NPI:1114248317
Name:RIVERA, ORLANDO (RT (R)(CT))
Entity Type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:
Last Name:RIVERA
Suffix:
Gender:M
Credentials:RT (R)(CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 HALE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8408
Mailing Address - Country:US
Mailing Address - Phone:956-230-0109
Mailing Address - Fax:800-660-8632
Practice Address - Street 1:2114 HALE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8408
Practice Address - Country:US
Practice Address - Phone:956-230-0109
Practice Address - Fax:800-660-8632
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261382471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography