Provider Demographics
NPI:1336433259
Name:RIVERA, ZULMA I
Entity Type:Individual
Prefix:MISS
First Name:ZULMA
Middle Name:I
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:PO BOX 804
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-0804
Mailing Address - Country:US
Mailing Address - Phone:787-617-3111
Mailing Address - Fax:
Practice Address - Street 1:URB. LLANOS 4TH ST. #F-21
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-0804
Practice Address - Country:US
Practice Address - Phone:787-617-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRPCVTE4593343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)