Provider Demographics
NPI:1952512907
Name:RIVERA, SHEILA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SC12 PLAZA 4
Mailing Address - Street 2:MANSIONESDELSUR
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4810
Mailing Address - Country:US
Mailing Address - Phone:787-784-5251
Mailing Address - Fax:787-782-0870
Practice Address - Street 1:SC12 PLAZA 4
Practice Address - Street 2:MANSIONSDELSUR
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-4810
Practice Address - Country:US
Practice Address - Phone:787-784-5251
Practice Address - Fax:787-782-0870
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6807174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist