Provider Demographics
NPI:1497084321
Name:ROBLES RIVERA, ESTEBAN
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:ROBLES RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/SANTA MARTA M-2
Mailing Address - Street 2:URB SANTA MARIA
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-251-1123
Mailing Address - Fax:
Practice Address - Street 1:C/SANTA MARTA M-2
Practice Address - Street 2:URB SANTA MARIA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-251-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2009-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR15031OtherLICENCE