Provider Demographics
NPI:1447595145
Name:RIERA, JACQUELINE DEL PILAR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:DEL PILAR
Last Name:RIERA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:8888 COLLINS AVENUE
Mailing Address - Street 2:APT. 406
Mailing Address - City:SURFSIDE
Mailing Address - State:FL
Mailing Address - Zip Code:33154-3541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8888 COLLINS AVE
Practice Address - Street 2:APT. 406
Practice Address - City:SURFSIDE
Practice Address - State:FL
Practice Address - Zip Code:33154-3539
Practice Address - Country:US
Practice Address - Phone:305-864-2674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT23650225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ087255TQZMedicare PIN