Provider Demographics
NPI:1285511493
Name:REYES RIVERA, KASANDRA
Entity type:Individual
Prefix:MISS
First Name:KASANDRA
Middle Name:
Last Name:REYES RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KASANDRA
Other - Middle Name:
Other - Last Name:REYES RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 60040
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-9128
Mailing Address - Country:US
Mailing Address - Phone:787-975-6293
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 60040
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-9128
Practice Address - Country:US
Practice Address - Phone:787-975-6293
Practice Address - Fax:787-975-6293
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-19
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR94759163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse