Provider Demographics
NPI:1720167091
Name:RIVERA, RUBEN II (NURSE)
Entity Type:Individual
Prefix:
First Name:RUBEN
Middle Name:
Last Name:RIVERA
Suffix:II
Gender:M
Credentials:NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 34310
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00934
Mailing Address - Country:US
Mailing Address - Phone:787-707-2176
Mailing Address - Fax:787-707-2045
Practice Address - Street 1:327 CALLE ALMACIGO
Practice Address - Street 2:MONTECASINO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3700
Practice Address - Country:US
Practice Address - Phone:787-707-2176
Practice Address - Fax:787-707-2045
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9252836163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator