Provider Demographics
NPI:1346559473
Name:PLAZA, MARIA RIVERA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:RIVERA
Last Name:PLAZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NUEVA VIDA EL TUQUE
Mailing Address - Street 2:N53 CALLE G
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-6728
Mailing Address - Country:US
Mailing Address - Phone:787-222-1595
Mailing Address - Fax:
Practice Address - Street 1:CALLE FERROCARRIL
Practice Address - Street 2:610 SANTA MARIA OFICCE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717
Practice Address - Country:US
Practice Address - Phone:787-284-5093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14165261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)