Provider Demographics
NPI:1023332483
Name:RIVERA, FE MILAGROS
Entity type:Individual
Prefix:MRS
First Name:FE
Middle Name:MILAGROS
Last Name:RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AVE MUNOZ RIVERA # 652
Mailing Address - Street 2:SUITE 3170
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1808
Mailing Address - Country:US
Mailing Address - Phone:787-247-2516
Mailing Address - Fax:
Practice Address - Street 1:AVE MUNOZ RIVERA # 652
Practice Address - Street 2:SUITE 3170
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-1808
Practice Address - Country:US
Practice Address - Phone:787-765-2305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1580103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist