Provider Demographics
NPI:1922126440
Name:RIVERA-HERNANDEZ, NILDA RAQUEL (MD)
Entity Type:Individual
Prefix:
First Name:NILDA
Middle Name:RAQUEL
Last Name:RIVERA-HERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PMB 214
Mailing Address - Street 2:PO BOX 144100
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-4100
Mailing Address - Country:US
Mailing Address - Phone:787-487-7325
Mailing Address - Fax:
Practice Address - Street 1:BARRIO PUEBLO, DESVIO NORTE
Practice Address - Street 2:CARRETERA ESTATAL 159, KM. 13.9
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783-0594
Practice Address - Country:US
Practice Address - Phone:787-859-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14002207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine