Provider Demographics
NPI:1629388566
Name:RIVERA PENA AND ASSOCIATES CORP
Entity Type:Organization
Organization Name:RIVERA PENA AND ASSOCIATES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FELIBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-293-8242
Mailing Address - Street 1:158 S. HOUSTON RD
Mailing Address - Street 2:UNIT # 12
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088
Mailing Address - Country:US
Mailing Address - Phone:478-293-8242
Mailing Address - Fax:678-623-0032
Practice Address - Street 1:158 S. HOUSTON RD
Practice Address - Street 2:UNIT # 12
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088
Practice Address - Country:US
Practice Address - Phone:478-293-8242
Practice Address - Fax:678-623-0032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center