Provider Demographics
NPI:1891883351
Name:RIVERA, ESTHER (OTL)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PERLA FINA ST. PARQUE ECUESTRE
Mailing Address - Street 2:N-25
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987-0987
Mailing Address - Country:US
Mailing Address - Phone:787-762-1880
Mailing Address - Fax:787-768-2936
Practice Address - Street 1:GENERAL VALERO AVE.
Practice Address - Street 2:#313-B
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738-0738
Practice Address - Country:US
Practice Address - Phone:787-249-3373
Practice Address - Fax:787-860-1993
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR420174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist