Provider Demographics
NPI:1992841530
Name:MORENU, FRANKLIN RIVEYA (PHD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:RIVEYA
Last Name:MORENU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:FRANKLIN
Other - Middle Name:RIVERA
Other - Last Name:MORENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 364
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0364
Mailing Address - Country:US
Mailing Address - Phone:787-265-0147
Mailing Address - Fax:787-265-0147
Practice Address - Street 1:MANANTIALES 832
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-265-0147
Practice Address - Fax:787-265-0147
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR731103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
89240Medicare ID - Type Unspecified