Provider Demographics
NPI:1982302204
Name:RIVERA RIVERA, YAHAIRA IVETTE (DPT)
Entity Type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:IVETTE
Last Name:RIVERA RIVERA
Suffix:
Gender:F
Credentials:DPT
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 376
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0376
Mailing Address - Country:US
Mailing Address - Phone:787-372-3410
Mailing Address - Fax:
Practice Address - Street 1:MARGINAL ELLIOT VELEZ URB. ATENAS J-20
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4616
Practice Address - Country:US
Practice Address - Phone:787-884-8923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR004594225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist