Provider Demographics
NPI:1750610747
Name:RIVERA PEREZ, MARIA V
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:V
Last Name:RIVERA PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:V
Other - Last Name:RIVERA PEREZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-1223
Mailing Address - Country:US
Mailing Address - Phone:787-231-4655
Mailing Address - Fax:
Practice Address - Street 1:CALLE ESMERALDA #10
Practice Address - Street 2:CARDEMAR CENTER URB TORITO PLATA
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-738-4157
Practice Address - Fax:787-263-2010
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR01311225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist