Provider Demographics
NPI:1497906127
Name:RIVERA SILVA, ZAIDA (MT)
Entity Type:Individual
Prefix:
First Name:ZAIDA
Middle Name:
Last Name:RIVERA SILVA
Suffix:
Gender:F
Credentials:MT
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 6143
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-6143
Mailing Address - Country:US
Mailing Address - Phone:787-826-6696
Mailing Address - Fax:787-826-6696
Practice Address - Street 1:CARR 401 KM 09
Practice Address - Street 2:BO HATILLO
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610
Practice Address - Country:US
Practice Address - Phone:787-826-6696
Practice Address - Fax:787-826-6696
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR003-1325Medicare PIN